Comparison Between Alendronate and Denosumab in Preventing Bone Loss and Lowering Fracture Risk Related to Adjuvant Endocrine Therapy for Breast Cancer: Real-World Data From a Third-Level Center Experience
Main finding · Change in BMD, TBS and major fracturesResult — go to the resultOdds ratio 0.34Authors' conclusion
Treatment with denosumab during AET improves BMD and TBS more than alendronate and is associated with a higher reduction in major fractures in postmenopausal patients affected by osteopenia or osteoporosis.
Study context
- Population
- Postmenopausal women on adjuvant endocrine therapy for breast cancermatched 1:1
- Participants
- 286 women
- Exposure
- Denosumab vs alendronate
- Outcome
- Change in BMD, TBS and major fractures
- Follow-up
- nearly 3-year follow-up
Methodological detailspropensity score matched, single-centre (third-level center), real-world data
- Propensity score matched
- Single-centre (third-level center)
- Real-world data
Main finding
As reported in the abstract
Odds ratio
0.34
P < 0.01
- Total hip bone mineral density (BMD) change, denosumab vs alendronate (g/cm²); P < .01
- +0.034 vs +0.002
- Femoral neck BMD change, denosumab vs alendronate (g/cm²); P < .01
- +0.014 vs 0.000
- Lumbar spine BMD change, denosumab vs alendronate (g/cm²); P < .01
- +0.053 vs +0.005
- Trabecular bone score (TBS) change, denosumab vs alendronate; P < .01
- +0.017 vs −0.027
Observational data: associations, not effects.
Further findings
Fracture risk in patients with normal BMD at baseline
- No significant difference between groups
Original publication
Comparison Between Alendronate and Denosumab in Preventing Bone Loss and Lowering Fracture Risk Related to Adjuvant Endocrine Therapy for Breast Cancer: Real-World Data From a Third-Level Center Experience. Endocr Pract. Published 11 July 2025. doi:10.
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