Sensitivity analyses confirmed the robustness of the findings across different covariate adjustments, data sources, and extended follow-up, consistently showing a lower risk of hypercalcemia and nonsignificant trends toward reduced fracture risk in the ROMO cohort.<h4>Conclusion</h4>Compared with PTH analogs, ROMO offers stronger short-term protection against osteoporotic fractures and hypercalcemia, particularly in older women with prior fractures. The gene discussed is PTH; the disease is Hypercalcemia.