ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2016
GRAND-4: the German retrospective analysis of long-term persistence in women with osteoporosis treated with bisphosphonates or denosumab.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Safety of denosumab versus zoledronic acid in the older adults with osteoporosis: a meta-analysis of cohort studies.Archives of osteoporosis · 2022Pooled it
- Persistence and adherence to parenteral osteoporosis therapies: a systematic review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Pooled it
- Factors associated with high 24-month persistence with denosumab: results of a real-world, non-interventional study of women with postmenopausal osteoporosis in Germany, Austria, Greece, and Belgium.Archives of osteoporosis · 2017Trial
- Denosumab-efficacy, safety, persistence and sequential strategies-a systematic review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
- Smartphone-based patient-reported outcome of acute phase reaction after zoledronic acid infusion and prediction algorithm: a multicenter, prospective cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Denosumab Offers Relatively Lower Initial Protection Against Osteoporotic Vertebral Fractures in Treatment-Naive Patients Compared With Zoledronate.Clinical pharmacology and therapeutics · 2026Article
- 24-month real-world persistence and compliance of denosumab versus alendronate among postmenopausal women with osteoporosis in Australia, Taiwan, South Korea, Hong Kong, and Singapore.Journal of bone and mineral metabolism · 2026Article
- Real-world persistence and compliance of denosumab versus alendronate among postmenopausal women with osteoporosis in Asia-Pacific.Journal of bone and mineral metabolism · 2026Article
- Cost-effectiveness of opportunistic osteoporosis screening using chest radiographs with deep learning in Germany.Aging clinical and experimental research · 2025Article
- Real-World Osteoporosis Treatment Gap and Costs in Spain: Data from Women with a First Fragility Fracture or Diagnosis of Postmenopausal Osteoporosis.Rheumatology and therapy · 2025Article
- Publication Trends in Osteoporosis Treatment: A 20-Year Bibliometric Analysis.Journal of bone metabolism · 2024Article
- Adherence of denosumab treatment for low bone mineral density in Japanese people living with HIV: a retrospective observational study.Journal of pharmaceutical health care and sciences · 2023Article
- Utilization patterns and factors associated with persistence of new users of anti-osteoporosis treatment in Denmark: a population-based cohort study.Archives of osteoporosis · 2023Article
- Cost-effectiveness of Denosumab for the Treatment of Postmenopausal Osteoporosis in Malaysia.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- Real-world effectiveness of osteoporosis treatments in Germany.Archives of osteoporosis · 2022Observational
- Single pharmacy governed denosumab home administration: optimal adherence by means of a fracture liaison service (FLS) and home care collaboration.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- Prevalence of FRAX risk factors and the osteoporosis treatment gap among women ≥ 70 years of age in routine primary care across 8 countries in Europe.Archives of osteoporosis · 2022Article
- Long-term persistence with denosumab: real-world data from the Austrian Osteoporosis Clinic (AOC). A retrospective data analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- Cancer Treatment-Induced Bone Loss: Role of Denosumab in Non-Metastatic Breast Cancer.Breast cancer (Dove Medical Press) · 2022Review
- Osteoporotic fractures and subsequent fractures: imminent fracture risk from an analysis of German real-world claims data.Archives of gynecology and obstetrics · 2021Observational
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledThis retrospective database study assessed 2-year persistence with bisphosphonates or denosumab in a large German cohort of women with a first-time prescription for osteoporosis treatment. Compared with intravenous or oral bisphosphonates, 2-year persistence was 1.5-2 times higher and risk of discontinuation was significantly lower (P < 0.0001) with denosumab.
introductionPersistence with osteoporosis therapies is critical for fracture risk reduction. Detailed data on long-term persistence (≥2 years) with bisphosphonates and denosumab are sparse.
methodsFrom the German IMS® database, we included women aged 40 years or older with a first-time prescription for bisphosphonates or denosumab between July 2010 and August 2014; patients were followed up until December 2014. The main outcome was treatment discontinuation, with a 60-day permissible gap between filled prescriptions. Two-year persistence was estimated using Kaplan-Meier survival curves, with treatment discontinuation as the failure event. Denosumab was compared with intravenous (i.v.) and oral bisphosphonates separately. Cox proportional hazard ratios (HRs) for the 2-year risk of discontinuation were calculated, with adjustment for age, physician specialty, health insurance status, and previous medication use.
resultsTwo-year persistence with denosumab was significantly higher than with i.v. or oral bisphosphonates (39.8 % [n = 21,154] vs 20.9 % [i.v. ibandronate; n = 20,472] and 24.8 % [i.v. zoledronic acid; n = 3966] and 16.7-17.5 % [oral bisphosphonates; n = 114,401]; all P < 0.001). Patients receiving i.v. ibandronate, i.v. zoledronic acid, or oral bisphosphonates had a significantly increased risk of treatment discontinuation than did those receiving denosumab (HR = 1.65, 1.28, and 1.96-2.02, respectively; all P < 0.0001).
conclusionsTwo-year persistence with denosumab was 1.5-2 times higher than with i.v. or oral bisphosphonates, and risk of discontinuation was significantly lower with denosumab than with bisphosphonates. A more detailed understanding of factors affecting medication-taking behavior may improve persistence and thereby reduce rates of fracture.
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