Least squares mean bone strength percentage change from baseline at the lumbar spine with romosozumab or alendronate treatment at months 6, 12, and 24 by FEA: integral bone strength (A), cortical bone strength (B), and trabecular bone strength (C). n = number of randomized patients enrolled in the QCT/FEA imaging component of the ARCH substudy with values at baseline and one or more postbaseline visits; n1 = number of patients with values at that time point. Month 6 and month 12 measurements were during the double‐blind period where patients received monthly romosozumab 210 mg sc or weekly oral alendronate 70 mg for 12 months; month 24 measurements were during the open‐label period when patients received weekly oral open‐label alendronate 70 mg for 12 months. Data were based on ANCOVA model, adjusting for presence of severe vertebral fracture at baseline and baseline FEA value. Missing values were imputed by carrying forward the last nonmissing postbaseline value prior to the missing value and within the treatment period. Abbreviations: ALN, alendronate; ANCOVA, analysis of covariance; ARCH, Active‐Controlled Fracture Study in Postmenopausal Women With Osteoporosis at High Risk; Diff, difference between the treatment groups; FEA, finite element analysis; QCT, quantitative computed tomography; ROMO, romosozumab.