Rates of osteoporotic fracture are similar three years after starting either denosumab or alendronate, according to a real-world Danish population-based cohort study.

Using national registries, the team investigated fracture risk in people aged 50 and older (mean age 71, 81% female) who were starting denosumab (4624 patients) or alendronate (87,731 patients).

The three-year cumulative incidence of hospitalisation for hip fracture was 3.7% in the denosumab cohort and 3.1% in the alendronate cohort — a difference that did not reach statistical significance.

Meanwhile, the cumulative incidence of hospital attendance for any fracture was 9.0% for both cohorts, the authors reported in JAMA Network Open.