{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:26:38Z","timestamp":1793917598512,"version":"4.8.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen Inc.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Although clinical trials have shown that denosumab significantly increases bone mineral density at key skeletal sites more than oral bisphosphonates, evidence is lacking from head-to-head randomized trials evaluating fracture outcomes. This retrospective cohort study uses administrative claims data from Medicare fee-for service beneficiaries to evaluate the comparative effectiveness of denosumab vs alendronate in reducing fracture risk among women with PMO in the US. Women with PMO\u2009\u2265\u200966\u00a0yr of age with no prior history of osteoporosis treatment, who initiated denosumab (n\u2009=\u200989\u2009115) or alendronate (n\u2009=\u2009389\u2009536) from 2012 to 2018, were followed from treatment initiation until the first of a specific fracture outcome, treatment discontinuation or switch, end of study (December 31, 2019), or other censoring criteria. A doubly robust inverse-probability of treatment and censoring weighted function was used to estimate the risk ratio associated with the use of denosumab compared with alendronate for hip, nonvertebral (NV; includes hip, humerus, pelvis, radius\/ulna, other femur), non-hip nonvertebral (NHNV), hospitalized vertebral (HV), and major osteoporotic (MOP; consisting of NV and HV) fractures. Overall, denosumab reduced the risk of MOP by 39%, hip by 36%, NV by 43%, NHNV by 50%, and HV fractures by 30% compared with alendronate. Denosumab reduced the risk of MOP fractures by 9% at year 1, 12% at year 2, 18% at year 3, and 31% at year 5. An increase in the magnitude of fracture risk reduction with increasing duration of exposure was also observed for other NV fracture outcomes. In this cohort of almost half-a-million treatment-naive women with PMO, we observed clinically significant reductions in the risk of MOP, hip, NV, NHNV, and HV fractures for patients on denosumab compared with alendronate. Patients who remained on denosumab for longer periods of time experienced greater reductions in fracture risk.<\/jats:p>","DOI":"10.1093\/jbmr\/zjae079","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T17:00:20Z","timestamp":1715792420000},"page":"826-834","source":"Crossref","is-referenced-by-count":58,"title":["Comparative effectiveness of denosumab vs alendronate among postmenopausal women with osteoporosis"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8907-8976","authenticated-orcid":false,"given":"Jeffrey R","family":"Curtis","sequence":"first","affiliation":[{"name":"University of Alabama at Birmingham , Division of Clinical Immunology and Rheumatology, Birmingham, AL, 35233 , United States"},{"name":"Foundation for Advancing Science , Technology, Education and Research, Birmingham, AL, 35244 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0837-6873","authenticated-orcid":false,"given":"Tarun","family":"Arora","sequence":"additional","affiliation":[{"name":"Foundation for Advancing Science , Technology, Education and Research, Birmingham, AL, 35244 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1536-706X","authenticated-orcid":false,"given":"Ye","family":"Liu","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham , Division of Clinical Immunology and Rheumatology, Birmingham, AL, 35233 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8333-7666","authenticated-orcid":false,"given":"Tzu-Chieh","family":"Lin","sequence":"additional","affiliation":[{"name":"Amgen Inc. , Center for Observational Research, Thousand Oaks, CA, 91320 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Spangler","sequence":"additional","affiliation":[{"name":"Amgen Inc. , Center for Observational Research, Thousand Oaks, CA, 91320 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5340-1233","authenticated-orcid":false,"given":"Vanessa C","family":"Brunetti","sequence":"additional","affiliation":[{"name":"Amgen Ltd. , Center for Observational Research, Uxbridge, UB8 1DH , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Kees","family":"Stad","sequence":"additional","affiliation":[{"name":"Amgen Inc. , Global Medical, Thousand Oaks, CA, 91320 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"McDermott","sequence":"additional","affiliation":[{"name":"Amgen Inc. , Global Medical, Thousand Oaks, CA, 91320 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian D","family":"Bradbury","sequence":"additional","affiliation":[{"name":"Amgen Inc. , Center for Observational Research, Thousand Oaks, CA, 91320 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0746-2446","authenticated-orcid":false,"given":"Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Amgen Inc. , Center for Observational Research, Thousand Oaks, CA, 91320 , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"issue":"1-2","key":"2024080612124313900_ref1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1007\/s11657-013-0136-1","article-title":"Osteoporosis in the European Union: medical management, epidemiology and economic burden. 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