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Participants received either a bi-annual denosumab injection or weekly oral alendronate as osteoporosis treatment, based on physician judgment. Multivariable logistic regression assessed whether therapy\u00a0(denosumab or alendronate) was significantly associated with treatment persistence and compliance over 24\u00a0months of follow-up. The models were adjusted for age, fracture history, baseline bone mineral density (BMD), prior osteoporosis therapy, and prior oral glucocorticoid treatment. 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 687 enrolled patients, 549 completed their 24-month visit (295 in denosumab and 254 in alendronate group). Patients in the denosumab group were older and a higher proportion previously received osteoporosis treatment. Overall treatment persistence and compliance were 74.9% and 56.6%, respectively. Patients prescribed with denosumab exhibited higher persistence (86.1% vs. 61.8%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and compliance (62.4% vs. 50.0%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004), compared with those on alendronate. Regression results also demonstrated that patients receiving denosumab were more likely to be persistent (aOR\u2009=\u20093.91; 95% CI 2.52\u20136.08), and compliant (aOR\u2009=\u20091.61; 95% CI 1.12\u20132.31). BMD T-scores improved in both the treatment groups after 24\u00a0months with no significant association between treatment type and change in T-score. No significant difference was also observed in the occurrence of adverse events between the two treatment cohorts. Patients on alendronate reported gastrointestinal issues more frequently, whereas those on denosumab had a higher incidence of bone and joint injuries.\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 a bi-annual denosumab injection, compared with weekly oral alendronate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00774-026-01736-w","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T12:27:05Z","timestamp":1781699225000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["24-month real-world persistence and compliance of denosumab versus alendronate among postmenopausal women with osteoporosis in Australia, Taiwan, South Korea, Hong Kong, and Singapore"],"prefix":"10.1007","author":[{"given":"Tang Ching","family":"Lau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Gune","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Hwan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith M. 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See-Hwee Yeo is an employee of Real World Solutions, IQVIA Solutions Asia at time of study. 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 Inc.) or IQVIA.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki, and the study protocol received ethical approval from the Institutional Review Board of all local sites.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}