Trial reportThe Journal of clinical endocrinology and metabolism2020
Bone Mineral Density After Transitioning From Denosumab to Alendronate.
Trial report in The Journal of clinical endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 60 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multicenter, Randomized, Cross-Over, Open-label Study to Evaluate the Adherence, Preference, and Satisfaction of Denosumab and Alendronate in Postmenopausal Women With Low Bone Mineral Density
The Comparison of Ibandronate and Zoledronic Acid After Denosumab Discontinuation: A Randomized Non-inferiority Trial
Who cites it
60 citing papers in PubMed, 7 syntheses or guidelines pooled it, 111 citations in OpenAlex.
- Adverse Gastrointestinal Effects of Alendronate Versus Risedronate in Osteoporosis: A Systematic Review and Meta-analysis.Annals of African medicine · 2026Pooled it
- The 2024 UK clinical guideline for the prevention and treatment of osteoporosis.Archives of osteoporosis · 2025Guideline
- Optimization of high-intensity resistance exercise protocols for improving bone mineral density in the elderly without chronic diseases: a systematic review and network meta-analysis.Frontiers in physiology · 2025Pooled it
- [Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research].Wiener klinische Wochenschrift · 2024Guideline
- Fracture risk reduction and safety by osteoporosis treatment compared with placebo or active comparator in postmenopausal women: systematic review, network meta-analysis, and meta-regression analysis of randomised clinical trials.BMJ (Clinical research ed.) · 2023Pooled it
- UK clinical guideline for the prevention and treatment of osteoporosis.Archives of osteoporosis · 2022Guideline
- Osteoporosis Management in the Era of COVID-19.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2020Guideline
- One versus 2 years of alendronate following denosumab: the CARD extension.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Trial
- The Effect of Zoledronic Acid on Bone Microarchitecture and Strength after Denosumab and Teriparatide Administration: DATA-HD Study Extension.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2023Trial
- Multiple Vertebral Fractures After Denosumab Discontinuation: FREEDOM and FREEDOM Extension Trials Additional Post Hoc Analyses.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Trial
- Twice-weekly teriparatide improves lumbar spine BMD independent of pre-treatment BMD and bone turnover marker levels.Journal of bone and mineral metabolism · 2021Trial
- 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
- [Interpretation of 2024 United Kingdom National Osteoporosis Guideline Group (NOGG) Clinical Guidelines: Prevention and Treatment of Osteoporosis].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Article
- Preventing Hip (Proximal Femoral) Fractures: An Evidence-Based Review for Clinicians.Journal of clinical medicine · 2026Review
- Discontinuing Long-Term Denosumab in Treating Fragile Bone: Why, for Whom, and How?Clinical pharmacology and therapeutics · 2026Review
- Challenges in Sequential Antiresorptive Therapy After Long-Term Denosumab Discontinuation: A Case Report and Narrative Review of the Literature.Journal of clinical medicine · 2026Review
- Denosumab Offers Relatively Lower Initial Protection Against Osteoporotic Vertebral Fractures in Treatment-Naive Patients Compared With Zoledronate.Clinical pharmacology and therapeutics · 2026Article
- In silico exploration of osteoclast precursor inhibition for preventing rapid bone loss after denosumab discontinuation.NPJ systems biology and applications · 2026Article
- Non-metastatic breast cancer patients discontinuing aromatase inhibitor on denosumab: what next?Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
- Mechanisms and management strategies for exacerbated bone loss following denosumab discontinuation.Frontiers in aging · 2026Review
Corrections and comments
- Commented on by
Authors and funding
8 authors at 7 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextThere are few studies on patients transitioning from denosumab to bisphosphonates.
objectiveTo investigate patient characteristics and changes in bone mineral density (BMD) after transitioning from denosumab to alendronate.
designRandomized, open-label, 2-year crossover Denosumab Adherence Preference Satisfaction (DAPS) study (NCT00518531).
setting25 study centers in the US and Canada. PATIENTS: Treatment-naïve postmenopausal women with BMD T-scores from -2.0 to -4.0.
interventionsThis post hoc analysis evaluated women randomized to subcutaneous denosumab 60 mg every 6 months in year 1 followed by once-weekly oral alendronate 70 mg in year 2.
main outcome measureA 3% BMD threshold identified participants who lost, maintained, or gained BMD in year 2 on alendronate.
resultsOf 126 participants randomized to denosumab, 115 (91%) transitioned to alendronate in year 2. BMD increased by 3% to 6% with denosumab in year 1 and by 0% to 1% with alendronate in year 2. After transitioning to alendronate, most participants maintained or increased BMD; 15.9%, 7.6%, and 21.7% lost BMD at the lumbar spine, total hip, and femoral neck, respectively. Few participants fell below their pretreatment baseline BMD value; this occurred most often in those who lost BMD in year 2. Women who lost BMD with alendronate in year 2 also showed a greater percent change in BMD with denosumab in year 1. The BMD change in year 2 was similar regardless of baseline characteristics or adherence to oral alendronate.
conclusionAlendronate can effectively maintain the BMD gains accrued after 1 year of denosumab in most patients, regardless of baseline characteristics.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.