A recent comparative study published in Biol Sex Differ reported that romosozumab outperformed parathyroid hormone (PTH 1–34) analogs in reducing osteoporotic fractures among women, finding superior fracture risk reduction alongside gains in bone mineral density. The investigators Lu, Wang and Yang analyzed trial data and outcomes to quantify relative benefits and safety signals. The data may influence prescribing choices in high‑risk postmenopausal women and inform formulary decisions where romosozumab and PTH analogs compete. Clinicians and payers should weigh fracture prevention benefits against known thrombotic and cardiovascular considerations when updating treatment algorithms.