Denosumab versus alendronate: real-world fracture risk


  • Mary Corcoran
  • Univadis Medical News
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Findings from a new study suggest that the initiation of denosumab and alendronate treatments is associated with similar risks of fracture over a three-year period.

The study, published in JAMA Network Open, compared the risk of hip and any fracture in 92,355 patients in Denmark treated with denosumab (4,624) and alendronate (87,731) in routine practice settings from May 2010 to December 2017 after at least one year without an anti-osteoporosis medication. The primary outcome was hospitalisation for hip fracture, and the secondary outcome was hospitalisation for any fracture.

The study found that initiation of denosumab versus alendronate was associated with three-year cumulative incidences of 3.7 per cent and 3.1 per cent for hip fracture, respectively, corresponding to an absolute risk difference of 0.6 per cent (95% CI −0.3% to 1.5%). Hazard ratios for hip fracture were similar for denosumab versus alendronate, regardless of sex or age. 

The initiation of denosumab and alendronate were both associated with a cumulative incidence of 9.0 per cent for any fracture.

The authors said the cost-effectiveness of denosumab treatment compared with alendronate is an argument for prescribing denosumab rather than alendronate to prevent hip fractures.

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