Khalid S, et al. - Researchers compared the clinical effectiveness of oral anti-osteoporosis agents (alendronate [reference group] vs OBP, strontium ranelate (SR), or selective estrogen receptor modulators [SERMs]) based on the observed risk of fracture while on treatment in primary care actual practice. They investigated two primary care records databases covering UK National Health Service and Catalan healthcare patients 1995–2014 and 2006–2014, identifying a total of 163,950 UK and 145,236 Catalan patients, respectively. SR users displayed a 26% excess hip fracture risk vs matched alendronate users, in line with placebo-controlled, randomized controlled trial findings. Conversely, SERM users had a 25% reduced hip fracture risk compared to alendronate users in a lower risk population.