I would encourage the title of this segment to be that Denosumab increases Trabecular Bone Score. No anti-resorptive can actually increase bone mass. BMD and in a complex way TBS assesses bone mineral and in the case of TBS, the pattern of distribution. Anti-resorptive drugs decrease bone remodeling and more mineral goes into the stable bone mass. More mineral may alter the BMC and also the edge detection of the interface between bone and soft tissue. Clearly BMD and TBS can increase but bone mass does not increase. I urge readers to look at paired biopsy studies.