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Article History

Received: 9 September 2025

Accepted: 14 December 2025

First Online: 26 January 2026

Declarations

:

: The Independent Scientific Advisory Committee (ISAC) approved the study (ISAC protocol application number: 18_137) and given that only de-identified routinely collected data were used, no further approvals were required.

: MTSS was supported by grants or contracts from the Oxford NIHR Musculoskeletal Biomedical Research Centre (BRC), and has received consultancy fees from Theramex. BK reports lecture fees and/or consulting honoraria from Pfizer, Sanofi, and Janssen. KR has received grant funding to their institution from Janssen, Amgen, Takeda, GSK, Celegene—Bristol Myers Squibb; honoraria from Janssen, Adaptive Biotech, Amgen, Takeda, AbbVie, Oncopeptides, Celgene – Bristol Myers Squibb, Pfizer, Recordati, and GSK; support for attending meetings and/or travel from BMS, Amgen, and Takeda; is an advisor for Janssen, Adaptive Biotech, Amgen, Recordati, Takeda, AbbVie, Oncopeptides, Celgene – Bristol Myers Squibb, Pfizer, Menarini Stemline, and GSK. RPV has received grants or contracts from UCB, and lecture fees and/or consulting honoraria from UCB, Amgen, and IOF. MKJ has received consulting fees from UCB, Nannox AI, Native Technologies Limited; honoraria from Amgen Ltd, Sanofi, UCB; support for attending meetings and/or travel from UCB; and has a leadership or fiduciary role on the Royal Osteoporosis Society Clinical Research Committee. The remaining authors declare no conflicts of interest relevant to this paper.