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The antiresorptive drug denosumab is administered in office every 6 months. As patients are often late for repeat injections, investigators used medical records from 790 U.K. general practices for the years to generate a model of a randomized trial assessing the implications of three dosing intervals for managing osteoporosis: On time (repeat injection within 4 weeks of the recommended time), short delay (4–16 weeks late), and long delay (>16 weeks late).
Among 2594 evaluable patients (mean age, 76; 94% women), 53% had a history of a major osteoporotic fracture. Of the 6144 injections administered, 1856 were on time. Cumulative risk for any fracture within 6 months of the recommended repeat injection was 27.3 per 1000 (on time), 32.2 (short …