Updates are available Correction dated 2025-09-30

Article History

Accepted: 8 July 2025

First Online: 11 August 2025

Change Date: 28 August 2025

Change Type: Update

Change Details: In the version of the article initially published, footnotes for equally contributing authors (now listing Nicholas Fuggle and René Rizzoli) and jointly supervising authors (now listing Jean-Yves Reginster and Nicholas C. Harvey) were incorrect and are now amended in the HTML and PDF versions of the article.

Change Date: 30 September 2025

Change Type: Correction

Change Details: A Correction to this paper has been published:

Change Details: https://doi.org/10.1038/s41584-025-01314-w

Competing interests

: N.F. has received honoraria and speaker fees from UCB and Viatris, and travel bursaries from Eli Lilly and Pfizer. B.C. has received occasional fees as an expert or speaker from Alexion, Amgen, Aptissen, Expanscience, Lilly, Kyowa Kirin, Novartis, Theramex, UCB and Viatris. E.M.C. has received speaker fees from Eli Lilly, Thornton and Ross, and UCB, and travel bursaries or conference support from Amgen and Eli Lilly. M.H. has received research grants (paid to his institution) from Angelini Pharma and Radius Health, and lecture fees from IBSA (paid to his institution) and Mylan Pharmaceuticals, and was grant adviser for Pfizer (paid to his institution). N.V. declares personal fees from Bayer, Fidia, Nestlè and Viatris. B.H.A. reports research grants from Amgen and UCB, and honoraria from Amgen, Theramex and UCB. M.L.B. declares honoraria from Amgen, Ascendis, Bruno Farmaceutici, Calcilytix and Kyowa Kirin, grants or speaker fees from Alexion, Amgen, Amolyt, Bruno Farmaceutici, CoGeDi, Echolight, Gedeon Richter, Kyowa Kirin, Monte Rosa Therapeutics and UCB, and consultancy for Aboca, Alexion, Amolyt, Bruno Farmaceutici, Calcilytix, Echolight, Enterabio, Kyowa Kirin, Personal Genomics and Septern. O.B. has received consulting or lecture fees from Amgen, Aptissen, Biophytis, IBSA, Mylan, Novartis, Nutricia, Orifarm, Sanofi, UCB and Viatris outside the submitted work. E. Casado has received honoraria and speaker fees from FAES, Gedeon-Richter, STADA, Theramex and UCB, and travel bursaries from Amgen, Rubió, STADA and Theramex. M.C. has received honoraria and travel grants from Amgen and Promedius AI solutions. P.D'A. declares research grants and honoraria from ErreKappa, Nestlé, OM Pharma and Schwabe Pharma. P.R.E. declares research grants from Amgen, Alexion and Sanofi, and honoraria from Amgen, Alexion and Kyowa Kirin. J.A.K. is a director of Osteoporosis Research, which maintains FRAX. A.K. declares honoraria for scientific advisory board, research grants and speakers fees from AgNovos bioscience, Alexion, Amgen, Celltrion Deutschland, Echolight, Eli Lilly, Ipsen, Imaging Biopsy Lab (IBL), Kyowa Kirin, Merit Medical, new4med, Novartis, NovoNordisk, Roche, Sandoz, Servier, Stadapharm, Theramex and UCB. E.McC. is a director of Osteoporosis Research, which maintains FRAX, and has also received honoraria and research funding from Amgen, Fresenius Kabi, Lilly, ObsEva, Radius Pharma, Theramex and UCB. M.McC. declares consulting fees or honoraria from Amgen, Alexion, Pfizer and UCB. O.M. declares lecture fees or honoraria from Bottu Johnson and Johnson, Pfizer and Sanofi. J.-Y.R. declares speaker’s Bureau for Radius Health and Theramex, and consultancy agreement for Theramex. N.C.H. has received personal fees, consultancy, lecture fees or honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Internis Pharma, Kyowa Kirin, Servier, Shire, Consilient Healthcare, Theramex and UCB outside the submitted work. R.R., C.B., J.-M.K, N.A.-D., M.A., N.B., C. Campusano, E. Cavalier, C. Cooper, B.D.-H., R.M., N.N., R.P. R., F.R., S.S. S.T., and L.Z. have no competing interests to declare.