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Study participants were prescribed bi-annual denosumab injection or weekly alendronate, based on physicians\u2019 decision. Medication persistence and compliance were estimated over 12 months of follow-up. Multivariable logistic regression was used to determine if treatment type (denosumab or alendronate) was significantly associated with persistence and compliance, while adjusting for age, fracture history, baseline BMD, prior osteoporosis treatment, and prior treatment with oral glucocorticoids. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 686 enrolled women, 580 completed their 12-month visit (301 in denosumab and 279 in alendronate group). At baseline, those in the denosumab group were older and more likely to have received prior osteoporosis treatment. Overall treatment persistence and compliance were 72.4% and 70.7%, respectively. Patients receiving denosumab exhibited higher persistence (82.7% vs. 61.3%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and compliance (86.0% vs. 54.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), versus those on alendronate. Regression results also showed that patients on denosumab were more likely to be persistent (aOR\u2009=\u20093.08; 95% CI 2.04\u20134.63) and compliant (aOR\u2009=\u20095.32; 95% CI 3.45\u20138.21) with treatment. Gastrointestinal disorders were more frequently reported in the alendronate group, while bone and joint injuries were more common in the denosumab group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Postmenopausal women with osteoporosis were more likely to be persistent and compliant with denosumab, compared with weekly oral alendronate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00774-025-01663-2","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T05:19:49Z","timestamp":1763529589000},"page":"69-83","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real-world persistence and compliance of denosumab versus alendronate among postmenopausal women with osteoporosis in Asia\u2013Pacific"],"prefix":"10.1007","volume":"44","author":[{"given":"Tang Ching","family":"Lau","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong-Gune","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Hwan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edith M. 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Pharmacoepidemiol Drug Saf 29:538\u2013549","journal-title":"Pharmacoepidemiol Drug Saf"}],"container-title":["Journal of Bone and Mineral Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00774-025-01663-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00774-025-01663-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00774-025-01663-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T20:03:53Z","timestamp":1770753833000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00774-025-01663-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,19]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["1663"],"URL":"https:\/\/doi.org\/10.1007\/s00774-025-01663-2","relation":{},"ISSN":["0914-8779","1435-5604"],"issn-type":[{"value":"0914-8779","type":"print"},{"value":"1435-5604","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,19]]},"assertion":[{"value":"9 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Shuang Huang, Cae Tolman, Laura Canals are employees and stockholders of Amgen Inc. See-Hwee Yeo and Jing Yu are employees of Real World Solutions, IQVIA Solutions Asia. Peter R. Ebeling received research funding and honoraria from Amgen. Other authors report no other potential conflicts of interest. The study medications (denosumab and alendronate) were not reimbursed by Sponsor (Amgen) or IQVIA.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study protocol received ethical approval from the Institutional Review Board of all local sites (Supplementary Table\u00a06).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All the results presented in this article are in aggregate form, and no personally identifiable information was used for this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}