042). Cortical perimeter increased significantly from baseline in both the ELD group (2.63 ± 7.52%, p = 0.008) and the ALF group (3.86 ± 6.28%, p < 0.001). Thus, although there was no significant difference between the effects of the two drugs on the increased cortical perimeter, ELD prevented the decrease in cortical thickness. Cortical vBMD of the femoral neck increased

significantly in both the ELD group (1.82 ± 4.78%, p = 0.004) and the ALF group (2.21 ± 4.98%, p < 0.001), with no difference between the two groups ( Fig. 1). Trabecular vBMD of the femoral neck significantly decreased in both the ALF group (− 7.49 ± 8.82%, p < 0.001) and the ELD group (− 3.99 ± 7.83%, p < 0.001), and there was a significant difference between the two groups (p = 0.020). Total vBMD EPZ015666 of the femoral neck decreased from baseline in the ALF group (− 2.25 ± 5.32%, p < 0.001), whereas it was maintained in the ELD group. Accordingly, the percentage changes in total vBMD differed significantly between the ELD and ALF groups (p = 0.009). Regarding cortical CSA, the ELD group showed a non-significant trend for an increase (1.73 ± 7.62%,

p = 0.082) and the ALF group showed a non-significant trend for a decrease (− 0.96 ± 6.14%, p = 0.212) ( Fig. 1). Thus, the percentage changes from the baseline in cortical CSA showed a significant difference between the ELD and ALF groups (p = 0.031). Trabecular CSA of the femoral Megestrol Acetate neck increased significantly in the ALF group (2.92 ± 7.74, p = 0.003), but not in the ELD group (1.92 ± 7.61%, p = 0.054). Total CSA increased from the baseline in both the Caspase pathway ELD group (1.69 ± 6.78%, p = 0.056) and the ALF group (1.51 ± 5.77%, p = 0.039), with no difference between the two groups. Cortical bone mass of the femoral neck increased significantly from baseline in both the ELD group (3.68 ± 7.51%, p < 0.001) and the ALF group (2.45 ± 9.64%, p = 0.045) ( Fig. 1). Total bone mass of the

femoral neck increased significantly only in the ELD group (1.93 ± 5.89, p = 0.013). Trabecular bone mass significantly decreased in the ALF group (− 3.96 ± 9.39, p < 0.001), whereas it did not change from baseline in the ELD group, and there was no significant difference between the two groups (p = 0.268). Thus, in the ELD group, both total and cortical bone mass increased from baseline, and trabecular bone mass was maintained. Biomechanical properties (CSMI, SM, and BR) of the femoral neck were compared between the ELD group and the ALF group (Fig. 2). CSMI and SM improved significantly in the ELD group (5.30 ± 11.56%, p < 0.001 for CSMI; 4.33 ± 11.92%, p = 0.006 for SM), whereas these parameters did not change in the ALF group. Thus, there were significant differences between the ELD and ALF groups in the percentage changes of CSMI and SM from baseline (p = 0.037 and p = 0.023, respectively).