Men's Osteoporosis Support Group
Denosumab, alendronate and treatment adherence
Osteoporos Int. 2011 Sep 17. [Epub ahead of print]. Final results of the DAPS (Denosumab Adherence Preference Satisfaction) study: a 24-month, randomized, crossover comparison with alendronate in postmenopausal women. Freemantle N and others. PMID: 21927922. This two-year cross-over study involved 250 post-menopausal women who received denosumab (Prolia) and alendronate (Fosamax) for one year before switching to the other medication. The purpose was to compare the adherence between injections of denosumab every six months and oral alendronate once-weekly. (In summary, this study tested which treatment regimen the women preferred: twice-yearly denosumab or once-weekly alendronate.
The study found significantly better adherence, as well as compliance and persistence, with the denosumab when compared to the alendronate. The participants also expressed treatment preference of 92.4% for the injections compared to the oral therapy. The authors concluded, “Based on the final results of this crossover study after women had received each treatment for up to 1 year, postmenopausal women with osteoporosis were more adherent, compliant, and persistent with subcutaneous denosumab injections every 6 months than with once-weekly alendronate tablets and reported increased treatment preference and satisfaction with injectable denosumab over oral alendronate.”
Editor's comments. Denosumab is not currently approved for men with osteoporosis, but could be used as an off-label medication. Presumably men would also find it easier to adhere to a long-term program with it since it requires only two injections per year to treat osteoporosis. So discuss this treatment option with your care provider if twice-yearly injections would interest you.