Comparison of anti-fracture effectiveness of zoledronate, ibandronate and alendronate versus denosumab in a registry-based cohort study
An erratum to this article was published (Osteoporos Int, Nov 2023 ↗)
Authors' conclusion
When adjusting for disease severity, denosumab was associated with significantly greater risk reduction than alendronate and ibandronate for vertebral fractures. No difference in fracture risk reduction was found between zoledronate and denosumab.
Study context
- Population
- Patients with osteoporosis receiving bisphosphonates, denosumab or both sequentially, real-world setting (89% female; median age at treatment onset 69 years)89% female
- Participants
- 3,068 patients
- Exposure
- Zoledronate, ibandronate and alendronate vs denosumab
- Outcome
- Fracture risk (vertebral, non-vertebral, hip, any)
Methodological detailstime-varying co-variates, adjusted for baseline T-scores and TBS, inverse probability treatment weighting
- Time-varying co-variates
- Adjusted for baseline T-scores and TBS
- Inverse probability treatment weighting
Main finding
As reported in the abstract
Vertebral fractures, adjusted for age, baseline T-scores and TBS
Adjusted hazard ratio (CI)P value
Denosumabvs Alendronate
0.47(0.35–0.64)
P < 0.001Denosumabvs Ibandronate
0.70(0.53–0.91)
P = 0.009Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Any fractures, adjusted for age, baseline T-scores and TBSDenosumabvs Alendronate | aHR 0.62 (CI 0.51–0.76) | P < 0.001 | |
| Any fractures, adjusted for age, baseline T-scores and TBSDenosumabvs Ibandronate | aHR 0.77 (CI 0.64–0.92) | P = 0.004 | |
| Hip fractures, propensity weightingDenosumabvs Alendronate | HR 0.54 (CI 0.29–0.98) | P = 0.044 | |
| 0.20.5125Ratio (log scale) |
Vertebral, non-vertebral and hip fractures under treatment and drug holidays vs before treatment onset
- Risks significantly lower under all bisphosphonates, denosumab and drug holidays than before treatment onset
- all p < 0.001
Original publication
Comparison of anti-fracture effectiveness of zoledronate, ibandronate and alendronate versus denosumab in a registry-based cohort study. Osteoporos Int. Published 26 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →