Timeliness of antiresorptive consolidation after anabolic therapy for primary fracture prevention: A US cohort study
Authors' conclusion
Only 1 in 4 patients received timely consolidation therapy after osteoanabolic treatment, and 1 in 8 completed the full sequence.
Study context
- Population
- Adults aged ≥50 years who initiated romosozumab, teriparatide or abaloparatide for primary fracture prevention, 2011–2022; mean age 70.6 years, 89% women, 85% White
- Participants
- 15,389 adults
- Outcome
- Timely consolidation: initiation of an antiresorptive within 3 months after osteoanabolic therapy
- Follow-up
- Within 3 months
Methodological detailsclaims data (US commercial, Medicare Advantage, traditional Medicare), multivariable logistic regression
- Claims data (US commercial, Medicare Advantage, traditional Medicare)
- Multivariable logistic regression
Main finding
As reported in the abstract
Timely consolidation
Odds ratio (95% CI)
Endocrinologyvs Primary carepredictor of timely consolidation
1.31(1.17–1.48)
Rheumatologyvs Primary carepredictor of timely consolidation
1.45(1.30–1.62)
Aged 50-64 yearsvs Aged 65-74predictor of timely consolidation
0.67(0.58–0.77)
Medicare Advantagevs Traditional Medicarepredictor of timely consolidation
0.85(0.74–0.98)
Recently hospitalizedpredictor of timely consolidation
0.88(0.80–0.97)
2021 startsvs 2011 startsodds increased over time
4.27(3.63–5.05)
- Timely consolidation, overall
- 25%
Observational data: associations, not effects.
Secondary outcomes
Consolidation patterns: delayed consolidation, osteoanabolic restart, no consolidation
- Delayed consolidation
- 24%
- Restarted osteoanabolics
- 12%
- No consolidation
- 40%
Completion of osteoanabolic course
- Completed osteoanabolic therapy
- 30%
- Median duration, romosozumab
- 12.9 months
- Median duration, teriparatide/abaloparatide
- 23.4 months
- Completed therapy with timely consolidation
- 12%
Original publication
Timeliness of antiresorptive consolidation after anabolic therapy for primary fracture prevention: A US cohort study. J Clin Endocrinol Metab. Published 4 March 2026. doi:10.
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