Patient Preference and Adherence
Prescribing Trends of Osteoporosis Medications, Adherence and Persistence with Denosumab versus Alendronate: A Real-World Retrospective Study in China
By Jun Chen, Yuliang Huang, Puqing Liu and 1 others.
Abstract
Introduction
Osteoporosis, a common metabolic bone disease with high fracture risk and heavy global burden, requires long-term medication adherence and persistence for fracture prevention, yet both remain suboptimal. Prescribing trends, adherence, and persistence data for denosumab and alendronate remain limited, especially in Chinese populations.
Methods
This retrospective cohort study used hospital data. Patients aged ≥ 50 who newly initiated denosumab or alendronate in 2023– 2025 were screened; 2025 initiators were excluded for insufficient 1-year follow-up. New users had no prior prescription of either drug since 2009. The proportion of days covered (PDC) was assessed, with good adherence defined as ≥ 80%. Persistence was time from initiation to discontinuation, with > 60-day gap after coverage end defining discontinuation for both drugs. Propensity score matching (PSM) balanced baseline characteristics. Multivariable logistic regression and Kaplan-Meier survival analysis compared adherence and persistence.