Treatment patterns of #romosozumab in postmenopausal women with severe #osteoporosis in Denmark: findings from the ROmosozumab in Scandinavia real-world Evidence Study (ROSES)

To describe patient and prescriber characteristics and factors associated with utilization of romosozumab in Denmark.

Methods
This registry‑based Danish retrospective cohort study comprised females aged ≥ 50 receiving osteoporosis medication from September 2020 − October 2023. Three cohorts were identified: those treated with romosozumab (cohort 1), those with osteoporosis‑related fracture within the last three years treated with other osteoporosis medications (cohort 2), and those without osteoporosis‑related fracture within three years prior to initiating other osteoporosis medications (cohort 3). Patient and prescriber characteristics are presented by cohort. Factors associated with receiving romosozumab and transition of treatment are reported.

Results
Overall, 149,395 patients were included. Cohort 1 (n = 622) was younger, had lower proportions of comorbidities and use of glucocorticoids than cohorts 2 (n = 29,021) and 3 (n = 119,752). In cohort 1, 277 patients (44.5%) were osteoporosis treatment‑naïve and the majority received their index treatment from secondary endocrinological care. The median duration from romosozumab initiation to a recorded treatment transition was 350 days; most patients transitioned between 11–15 months to zoledronate (53.5%), alendronate (18.9%), or denosumab (13.5%).

Conclusion
This study provides real-world insight into patient and prescriber characteristics, and patterns and factors of romosozumab use across Denmark. Whilst a notable proportion of patients received romosozumab first in sequential therapy, there is still opportunity to optimize bone mineral density (BMD) outcomes with osteoanabolic agents used first, followed by an antiresorptive, in patients at high fracture risk. Of romosozumab-treated patients with 15 months follow-up data, most were assumed to continue romosozumab for 11–15 months when treatment transition was recorded.

https://link.springer.com/article/10.1007/s00198-025-07756-y