Table 3
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Incidence of Fractures by Site, Treatment, and Exposure Period

ParameterDenosumab (n = 67,046)Oral BPs (n = 52,914)Zoledronic acid (n = 41,700)Raloxifene (n = 11,660)Teriparatide (n = 7510)
Vertebral fracture, (‰PY [95% CI])
Baseline period8.78 [7.35–10.214.99 [3.77–6.20]19.22 [16.53–21.90]1.74 [0.56–4.06]34.75 [26.23–43.26]
3‐month to 12‐month period5.72 [4.94–6.49]2.76 [2.20–3.32]7.04 [6.10–7.98]1.06 [0.46–2.09]14.52 [11.21–17.82]
3‐month to 18‐month period5.25 [4.62–5.89]2.77 [2.30–3.25]7.14 [6.28–8.00]1.03 [0.42–1.64]12.03 [9.53–14.53]
3‐month to 24‐month period4.86 [4.30–5.42]2.81 [2.38–3.25]6.86 [6.08–7.64]0.92 [0.40–1.45]11.91 [9.48–14.35]
Hip fracture, (‰PY [95% CI])
Baseline period8.72 [7.30–10.14]3.37 2.38–4.37]10.52 [8.53–12.50]0.70 [0.08–2.51]8.65 [4.41–12.89]
3‐month to 12‐month period7.19 [6.32–8.06]5.29 [4.51–6.07]10.65 [9.50–11.80]0.27 [0.03–0.96]9.39 [6.73–12.04]
3‐month to 18‐month period6.61 [5.90–7.32]5.59 [4.91–6.27]9.68 [8.69–10.68]0.84 [0.39–1.60]9.57 [7.34–11.79]
3‐month to 24‐month period6.57 [5.92–7.22]5.58 [4.96–6.20]9.49 [8.57–10.40]0.85 [0.35–1.35]9.68 [7.49–11.87]
Wrist/forearm fracture (‰PY [95% CI])
Baseline period8.24 [6.85–9.62]6.37 [5.00–7.74]7.20 [5.56–8.84]4.87 [2.32–7.42]8.11 [4.00–12.21]
3‐month to 12‐month period6.68 [5.84–7.51]6.01 [5.18–6.83]8.15 [7.14–9.15]5.32 [3.67–6.96]10.19 [7.42–12.96]
3‐month to 18‐month period6.72 [6.00–7.43]5.94 [5.24–6.64]7.81 [6.92–8.71]5.07 [3.72–6.43]10.00 [7.72–12.27]
3‐month to 24‐month period6.79 [6.13–7.45]6.11 [5.46–6.76]7.60 [6.78–8.42]4.64 [3.46–5.81]9.57 [7.39–11.76]
Non‐hip nonvertebral fracture (‰PY [95% CI])
Baseline period22.08 [19.81–24.35]12.13 [10.24–14.02]21.85 [18.98–24.71]6.96 [3.91–10.01]16.23 [10.42–22.04]
3‐month to 12‐month period18.69 [17.29–20.10]12.75 [11.54–13.96]22.74 [21.05–24.43]10.25 [7.96–12.54]28.36 [23.73–32.99]
3‐month to 18‐month period18.29 [17.10–19.48]13.00 [11.97–14.04]21.58 [20.09–23.07]9.79 [7.91–11.67]25.70 [22.04–29.37]
3‐month to 24‐month period18.10 [17.02–19.18]13.28 [12.32–14.23]21.10 [19.73–22.48]8.91 [7.28–10.54]25.28 [21.72–28.83]
ParameterDenosumab (n = 67,046)Oral BPs (n = 52,914)Zoledronic acid (n = 41,700)Raloxifene (n = 11,660)Teriparatide (n = 7510)
Vertebral fracture, (‰PY [95% CI])
Baseline period8.78 [7.35–10.214.99 [3.77–6.20]19.22 [16.53–21.90]1.74 [0.56–4.06]34.75 [26.23–43.26]
3‐month to 12‐month period5.72 [4.94–6.49]2.76 [2.20–3.32]7.04 [6.10–7.98]1.06 [0.46–2.09]14.52 [11.21–17.82]
3‐month to 18‐month period5.25 [4.62–5.89]2.77 [2.30–3.25]7.14 [6.28–8.00]1.03 [0.42–1.64]12.03 [9.53–14.53]
3‐month to 24‐month period4.86 [4.30–5.42]2.81 [2.38–3.25]6.86 [6.08–7.64]0.92 [0.40–1.45]11.91 [9.48–14.35]
Hip fracture, (‰PY [95% CI])
Baseline period8.72 [7.30–10.14]3.37 2.38–4.37]10.52 [8.53–12.50]0.70 [0.08–2.51]8.65 [4.41–12.89]
3‐month to 12‐month period7.19 [6.32–8.06]5.29 [4.51–6.07]10.65 [9.50–11.80]0.27 [0.03–0.96]9.39 [6.73–12.04]
3‐month to 18‐month period6.61 [5.90–7.32]5.59 [4.91–6.27]9.68 [8.69–10.68]0.84 [0.39–1.60]9.57 [7.34–11.79]
3‐month to 24‐month period6.57 [5.92–7.22]5.58 [4.96–6.20]9.49 [8.57–10.40]0.85 [0.35–1.35]9.68 [7.49–11.87]
Wrist/forearm fracture (‰PY [95% CI])
Baseline period8.24 [6.85–9.62]6.37 [5.00–7.74]7.20 [5.56–8.84]4.87 [2.32–7.42]8.11 [4.00–12.21]
3‐month to 12‐month period6.68 [5.84–7.51]6.01 [5.18–6.83]8.15 [7.14–9.15]5.32 [3.67–6.96]10.19 [7.42–12.96]
3‐month to 18‐month period6.72 [6.00–7.43]5.94 [5.24–6.64]7.81 [6.92–8.71]5.07 [3.72–6.43]10.00 [7.72–12.27]
3‐month to 24‐month period6.79 [6.13–7.45]6.11 [5.46–6.76]7.60 [6.78–8.42]4.64 [3.46–5.81]9.57 [7.39–11.76]
Non‐hip nonvertebral fracture (‰PY [95% CI])
Baseline period22.08 [19.81–24.35]12.13 [10.24–14.02]21.85 [18.98–24.71]6.96 [3.91–10.01]16.23 [10.42–22.04]
3‐month to 12‐month period18.69 [17.29–20.10]12.75 [11.54–13.96]22.74 [21.05–24.43]10.25 [7.96–12.54]28.36 [23.73–32.99]
3‐month to 18‐month period18.29 [17.10–19.48]13.00 [11.97–14.04]21.58 [20.09–23.07]9.79 [7.91–11.67]25.70 [22.04–29.37]
3‐month to 24‐month period18.10 [17.02–19.18]13.28 [12.32–14.23]21.10 [19.73–22.48]8.91 [7.28–10.54]25.28 [21.72–28.83]

Abbreviation: BP = bisphosphonates; CI = confidence interval; PY = person year.

Table 3
Open in new tab

Incidence of Fractures by Site, Treatment, and Exposure Period

ParameterDenosumab (n = 67,046)Oral BPs (n = 52,914)Zoledronic acid (n = 41,700)Raloxifene (n = 11,660)Teriparatide (n = 7510)
Vertebral fracture, (‰PY [95% CI])
Baseline period8.78 [7.35–10.214.99 [3.77–6.20]19.22 [16.53–21.90]1.74 [0.56–4.06]34.75 [26.23–43.26]
3‐month to 12‐month period5.72 [4.94–6.49]2.76 [2.20–3.32]7.04 [6.10–7.98]1.06 [0.46–2.09]14.52 [11.21–17.82]
3‐month to 18‐month period5.25 [4.62–5.89]2.77 [2.30–3.25]7.14 [6.28–8.00]1.03 [0.42–1.64]12.03 [9.53–14.53]
3‐month to 24‐month period4.86 [4.30–5.42]2.81 [2.38–3.25]6.86 [6.08–7.64]0.92 [0.40–1.45]11.91 [9.48–14.35]
Hip fracture, (‰PY [95% CI])
Baseline period8.72 [7.30–10.14]3.37 2.38–4.37]10.52 [8.53–12.50]0.70 [0.08–2.51]8.65 [4.41–12.89]
3‐month to 12‐month period7.19 [6.32–8.06]5.29 [4.51–6.07]10.65 [9.50–11.80]0.27 [0.03–0.96]9.39 [6.73–12.04]
3‐month to 18‐month period6.61 [5.90–7.32]5.59 [4.91–6.27]9.68 [8.69–10.68]0.84 [0.39–1.60]9.57 [7.34–11.79]
3‐month to 24‐month period6.57 [5.92–7.22]5.58 [4.96–6.20]9.49 [8.57–10.40]0.85 [0.35–1.35]9.68 [7.49–11.87]
Wrist/forearm fracture (‰PY [95% CI])
Baseline period8.24 [6.85–9.62]6.37 [5.00–7.74]7.20 [5.56–8.84]4.87 [2.32–7.42]8.11 [4.00–12.21]
3‐month to 12‐month period6.68 [5.84–7.51]6.01 [5.18–6.83]8.15 [7.14–9.15]5.32 [3.67–6.96]10.19 [7.42–12.96]
3‐month to 18‐month period6.72 [6.00–7.43]5.94 [5.24–6.64]7.81 [6.92–8.71]5.07 [3.72–6.43]10.00 [7.72–12.27]
3‐month to 24‐month period6.79 [6.13–7.45]6.11 [5.46–6.76]7.60 [6.78–8.42]4.64 [3.46–5.81]9.57 [7.39–11.76]
Non‐hip nonvertebral fracture (‰PY [95% CI])
Baseline period22.08 [19.81–24.35]12.13 [10.24–14.02]21.85 [18.98–24.71]6.96 [3.91–10.01]16.23 [10.42–22.04]
3‐month to 12‐month period18.69 [17.29–20.10]12.75 [11.54–13.96]22.74 [21.05–24.43]10.25 [7.96–12.54]28.36 [23.73–32.99]
3‐month to 18‐month period18.29 [17.10–19.48]13.00 [11.97–14.04]21.58 [20.09–23.07]9.79 [7.91–11.67]25.70 [22.04–29.37]
3‐month to 24‐month period18.10 [17.02–19.18]13.28 [12.32–14.23]21.10 [19.73–22.48]8.91 [7.28–10.54]25.28 [21.72–28.83]
ParameterDenosumab (n = 67,046)Oral BPs (n = 52,914)Zoledronic acid (n = 41,700)Raloxifene (n = 11,660)Teriparatide (n = 7510)
Vertebral fracture, (‰PY [95% CI])
Baseline period8.78 [7.35–10.214.99 [3.77–6.20]19.22 [16.53–21.90]1.74 [0.56–4.06]34.75 [26.23–43.26]
3‐month to 12‐month period5.72 [4.94–6.49]2.76 [2.20–3.32]7.04 [6.10–7.98]1.06 [0.46–2.09]14.52 [11.21–17.82]
3‐month to 18‐month period5.25 [4.62–5.89]2.77 [2.30–3.25]7.14 [6.28–8.00]1.03 [0.42–1.64]12.03 [9.53–14.53]
3‐month to 24‐month period4.86 [4.30–5.42]2.81 [2.38–3.25]6.86 [6.08–7.64]0.92 [0.40–1.45]11.91 [9.48–14.35]
Hip fracture, (‰PY [95% CI])
Baseline period8.72 [7.30–10.14]3.37 2.38–4.37]10.52 [8.53–12.50]0.70 [0.08–2.51]8.65 [4.41–12.89]
3‐month to 12‐month period7.19 [6.32–8.06]5.29 [4.51–6.07]10.65 [9.50–11.80]0.27 [0.03–0.96]9.39 [6.73–12.04]
3‐month to 18‐month period6.61 [5.90–7.32]5.59 [4.91–6.27]9.68 [8.69–10.68]0.84 [0.39–1.60]9.57 [7.34–11.79]
3‐month to 24‐month period6.57 [5.92–7.22]5.58 [4.96–6.20]9.49 [8.57–10.40]0.85 [0.35–1.35]9.68 [7.49–11.87]
Wrist/forearm fracture (‰PY [95% CI])
Baseline period8.24 [6.85–9.62]6.37 [5.00–7.74]7.20 [5.56–8.84]4.87 [2.32–7.42]8.11 [4.00–12.21]
3‐month to 12‐month period6.68 [5.84–7.51]6.01 [5.18–6.83]8.15 [7.14–9.15]5.32 [3.67–6.96]10.19 [7.42–12.96]
3‐month to 18‐month period6.72 [6.00–7.43]5.94 [5.24–6.64]7.81 [6.92–8.71]5.07 [3.72–6.43]10.00 [7.72–12.27]
3‐month to 24‐month period6.79 [6.13–7.45]6.11 [5.46–6.76]7.60 [6.78–8.42]4.64 [3.46–5.81]9.57 [7.39–11.76]
Non‐hip nonvertebral fracture (‰PY [95% CI])
Baseline period22.08 [19.81–24.35]12.13 [10.24–14.02]21.85 [18.98–24.71]6.96 [3.91–10.01]16.23 [10.42–22.04]
3‐month to 12‐month period18.69 [17.29–20.10]12.75 [11.54–13.96]22.74 [21.05–24.43]10.25 [7.96–12.54]28.36 [23.73–32.99]
3‐month to 18‐month period18.29 [17.10–19.48]13.00 [11.97–14.04]21.58 [20.09–23.07]9.79 [7.91–11.67]25.70 [22.04–29.37]
3‐month to 24‐month period18.10 [17.02–19.18]13.28 [12.32–14.23]21.10 [19.73–22.48]8.91 [7.28–10.54]25.28 [21.72–28.83]

Abbreviation: BP = bisphosphonates; CI = confidence interval; PY = person year.

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