{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:46:17Z","timestamp":1789047977522,"version":"build-2803163510"},"reference-count":14,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T00:00:00Z","timestamp":1527120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>In women with postmenopausal osteoporosis, we investigated the effects of 24 months of treatment with alendronate (ALN) following 18 months of treatment with abaloparatide (ABL) or placebo (PBO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Women who completed ABL or PBO treatment in ACTIVE were eligible to receive up to 24 months of ALN. We evaluated the incidence of vertebral and nonvertebral fractures and changes in bone mineral density (BMD) during the entire 43-month period from ACTIVE baseline to the end of ACTIVExtend and for the 24-month extension only.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five hundred fifty-eight women from ACTIVE\u2019s ABL group and 581 from its PBO group (92% of ABL and PBO completers) were enrolled. During the full 43-month treatment period, 0.9% of evaluable women in the ABL\/ALN group experienced a new radiographic vertebral fracture vs 5.6% of women in the PBO\/ALN group, an 84% relative risk reduction (RRR, P &amp;lt; 0.001). Kaplan\u2013Meier incidence rates for other reported fracture types were significantly lower for ABL\/ALN vs PBO\/ALN (all P &amp;lt; 0.05). Gains in BMD achieved during ACTIVE were further increased during ACTIVExtend. For ACTIVExtend only, RRR for vertebral fractures was 87% with ABL\/ALN vs PBO\/ALN (P = 0.001). Adverse events were similar between groups. A supplemental analysis for regulatory authorities found no hip fractures in the ABL\/ALN group vs five in the PBO\/ALN group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Eighteen months of ABL followed by 24 months of ALN reduced the risk of vertebral, nonvertebral, clinical, and major osteoporotic fractures and increased BMD. Sequential ABL followed by ALN appears to be an effective treatment option for postmenopausal women at risk for osteoporosis-related fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jc.2018-00163","type":"journal-article","created":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T14:28:43Z","timestamp":1527172123000},"page":"2949-2957","source":"Crossref","is-referenced-by-count":196,"title":["ACTIVExtend: 24 Months of Alendronate After 18 Months of Abaloparatide or Placebo for Postmenopausal Osteoporosis"],"prefix":"10.1210","volume":"103","author":[{"given":"Henry G","family":"Bone","sequence":"first","affiliation":[{"name":"Michigan Bone and Mineral Clinic, P.C., Detroit, Michigan"},{"name":"Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Cosman","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Columbia University, New York, New York"},{"name":"Clinical Research Center, Helen Hayes Hospital, West Haverstraw, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D","family":"Miller","sequence":"additional","affiliation":[{"name":"Colorado Center for Bone Research, Lakewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory C","family":"Williams","sequence":"additional","affiliation":[{"name":"Radius Health, Inc., Waltham, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Hattersley","sequence":"additional","affiliation":[{"name":"Radius Health, Inc., Waltham, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-yi","family":"Hu","sequence":"additional","affiliation":[{"name":"Radius Health, Inc., Waltham, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine A","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"Radius Health, Inc., Waltham, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Mitlak","sequence":"additional","affiliation":[{"name":"Radius Health, Inc., Waltham, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Socrates","family":"Papapoulos","sequence":"additional","affiliation":[{"name":"Center for Bone Quality, Leiden University Medical Center, ZA Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Rizzoli","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin K","family":"Dore","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P","family":"Bilezikian","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Columbia University College of Physicians and Surgeons, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth G","family":"Saag","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Rheumatology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2018,5,24]]},"reference":[{"issue":"5","key":"2020071623361287800_B1","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1002\/jbmr.2496","article-title":"Co-administration of antiresorptive and anabolic agents: a missed opportunity","volume":"30","author":"Seeman","year":"2015","journal-title":"J Bone Miner 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