{"doi":"10.1210/clinem/dgz321","title":"Delayed Denosumab Injections and Bone Mineral Density Response: An Electronic Health Record-based Study","abstract":"CONTEXT: Discontinuation of denosumab leads to a rapid reversal of its therapeutic effect. However, there are no data regarding how unintended delays or missed injections of denosumab impact bone mineral density (BMD) response. OBJECTIVE: We examined the association of delays in injections of denosumab with BMD change. DESIGN: We used electronic medical records from two academic hospitals from 2010 to 2017. PARTICIPANTS: Patients older than 45 years of age and used at least 2 doses of 60 mg denosumab. Denosumab adherence was evaluated by the medication coverage ratio (MCR). Good adherence corresponds to a dosing interval ≤7 months (defined by MCR ≥93%), moderate adherence corresponds to an interval of 7 to 10 months (MCR 75%-93%), and poor adherence corresponds to an interval ≥10 months (MCR ≤75%). OUTCOME MEASURES: Annualized percent BMD change from baseline at the lumbar spine, total hip, and femoral neck. RESULTS: We identified 938 denosumab injections among 151 patients; the mean (SD) age was 69 (10) years, and 95% were female. Patients with good adherence had an annualized BMD increase of 3.9% at the lumbar spine, compared with patients with moderate (3.0%) or poor adherence (1.4%, P for trend .002). Patients with good adherence had an annualized BMD increase of 2.1% at the total hip, compared with patients with moderate (1.3%) or poor adherence (0.6%, P for trend .002). CONCLUSIONS: A longer interval between denosumab injections is associated with suboptimal BMD response at both spine and total hip. Strategies to improve the timely administration of denosumab in real-world settings are needed.","journal":"The Journal of Clinical Endocrinology & Metabolism","year":2020,"id":92673,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":41,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9361,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":463466,"name":"Sizheng Steven Zhao","orcid":"0000-0002-3558-7353","position":1,"is_corresponding":false},{"id":388934,"name":"Kazuki Yoshida","orcid":"0000-0002-2030-3549","position":2,"is_corresponding":false},{"id":335237,"name":"Sara K. Tedeschi","orcid":"0000-0001-9475-1363","position":3,"is_corresponding":false},{"id":391214,"name":"Chang Xu","orcid":"0000-0002-5524-4550","position":4,"is_corresponding":false},{"id":434244,"name":"Sagar U. Nigwekar","orcid":"0000-0002-6750-0072","position":5,"is_corresponding":false},{"id":362060,"name":"Benjamin Z. Leder","orcid":"0000-0002-2051-0505","position":6,"is_corresponding":false},{"id":391215,"name":"Daniel H. Solomon","orcid":"0000-0001-8202-5428","position":7,"is_corresponding":false},{"id":463465,"name":"Houchen Lyu","orcid":"0000-0002-0128-0062","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-18T22:30:31.563852Z","pmid":"31894244","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}