{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T06:05:41Z","timestamp":1784009141032,"version":"3.55.0"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Key Research and Development Plan","award":["2022YFC3601904"],"award-info":[{"award-number":["2022YFC3601904"]}]},{"name":"National Key Research and Development Plan","award":["2022YFC3601900"],"award-info":[{"award-number":["2022YFC3601900"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Denosumab is an effective antiresorptive therapy for postmenopausal osteoporosis; however, long-term real-world data regarding sustained efficacy, treatment adherence, safety, and biochemical outcomes remain limited. This study evaluated the 36-month effectiveness and safety of denosumab in postmenopausal women with osteoporosis receiving routine clinical care.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This retrospective analysis included a prospectively followed real-world clinical cohort of 130 postmenopausal women with osteoporosis treated with denosumab (60\u202fmg subcutaneously every 6\u202fmonths) plus calcium and vitamin D supplementation. Participants were followed for 36\u202fmonths with assessments at baseline, 12, 24, and 36\u202fmonths. Outcomes included bone mineral density (BMD), T-scores, bone turnover markers, renal function, adherence patterns, prior treatment history, fracture occurrence, and adverse events. Changes over time were analyzed using paired longitudinal comparisons and linear mixed-effects models, with significance defined as\n p<\/jats:italic>\n \u202f&lt;\u202f0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Lumbar spine (L1\u2013L4) BMD increased from 0.674\u202f\u00b1\u202f0.120 to 0.741\u202f\u00b1\u202f0.102\u202fg\/cm\n 2<\/jats:sup>\n , while femoral neck BMD increased from 0.526\u202f\u00b1\u202f0.086 to 0.562\u202f\u00b1\u202f0.079\u202fg\/cm\n 2<\/jats:sup>\n over 36\u202fmonths (both\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). BMD improvements were accompanied by reductions in bone turnover markers, including\n \u03b2<\/jats:italic>\n -CTX and PINP, indicating sustained suppression of bone resorption. No clinically meaningful renal deterioration was observed during follow-up. Twenty-one participants had prior osteoporosis treatment history, whereas all included patients completed seven denosumab injections. Delayed injections occurred in 29 patients, although most delays were &lt;30\u202fdays. No new fragility fractures occurred during follow-up. No cases of osteonecrosis of the jaw, atypical femoral fracture, or injection-related serious adverse events were observed. Mild hypocalcemia occurred in several patients and resolved with monitoring and supplementation adjustment.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Thirty-six months of denosumab treatment was associated with sustained improvement in BMD, suppression of bone turnover, acceptable adherence, and a favorable safety profile in postmenopausal women with osteoporosis who completed the planned 36-month treatment course. Because only patients completing all seven injections with complete follow-up data were included, adherence, persistence, and safety outcomes may be overestimated compared with an intention-to-treat population. These findings support the effectiveness of denosumab under routine clinical practice while emphasizing the importance of continued monitoring and adherence management.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1825383","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:37:14Z","timestamp":1784007434000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Three-year longitudinal assessment of denosumab\u2019s efficacy and safety in postmenopausal osteoporosis: a 36-month real-world cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Rong-Lin","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, Tianjin Medical University General Hospital","place":["Tianjin, China"]},{"name":"Department of Osteo-Internal Medicine, Tianjin Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Tianjin Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Osteo-Internal Medicine, Tianjin Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai-Jun","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Osteo-Internal Medicine, Tianjin Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"275","DOI":"10.3390\/medicina61020275","article-title":"Update on osteoporosis","volume":"61","author":"Greco","year":"2025","journal-title":"Medicina"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1007\/s001980070064","article-title":"Long-term risk of osteoporotic fracture in Malm\u00f6","volume":"11","author":"Kanis","year":"2000","journal-title":"Osteoporos Int"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1186\/s13018-021-02772-0","article-title":"The global prevalence of osteoporosis: a comprehensive systematic review and meta-analysis","volume":"16","author":"Salari","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1456796","DOI":"10.3389\/fphar.2024.1456796","article-title":"Osteoporosis treatment: current drugs and future developments","volume":"15","author":"Chen","year":"2024","journal-title":"Front Pharmacol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.1210\/jc.2019-00221","article-title":"Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society clinical practice guideline","volume":"104","author":"Eastell","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/S2213-8587(17)30138-9","article-title":"Ten years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension","volume":"5","author":"Bone","year":"2017","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1056\/NEJMoa0809493","article-title":"Denosumab for prevention of fractures in postmenopausal women with osteoporosis","volume":"361","author":"Cummings","year":"2009","journal-title":"N Engl J Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s12325-021-01936-y","article-title":"Denosumab in the treatment of osteoporosis: 10 years later\u2014a narrative review","volume":"39","author":"Kendler","year":"2022","journal-title":"Adv Ther"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1002\/jbmr.3722","article-title":"Relationship between bone mineral density T-score and nonvertebral fracture risk over 10 years of denosumab treatment","volume":"34","author":"Ferrari","year":"2019","journal-title":"J Bone Miner Res"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.bone.2017.08.003","article-title":"Discontinuation of denosumab therapy for osteoporosis: a systematic review and position statement by ECTS","volume":"105","author":"Tsourdi","year":"2017","journal-title":"Bone"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1093\/jbmr\/zjaf037","article-title":"Denosumab discontinuation in the clinic: implications of rebound bone turnover and emerging strategies to prevent bone loss and fractures","volume":"40","author":"Kumar","year":"2025","journal-title":"J Bone Miner Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"47","DOI":"10.3803\/EnM.2024.2125","article-title":"Long-term efficacy and safety of denosumab: insights beyond 10 years of use","volume":"40","author":"Ha","year":"2025","journal-title":"Endocrinol Metab (Seoul)"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1825383\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:37:15Z","timestamp":1784007435000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1825383\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":12,"alternative-id":["10.3389\/fmed.2026.1825383"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1825383","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"article-number":"1825383"}}