Bilezikian JP, et al. - Via the FREEDOM trial of 2,207 subjects, the researchers investigated the long-term effect of denosumab treatment on upper limb fracture risk, a significant burden among postmenopausal women with osteoporosis, and bone mineral density (BMD). A crucial percentage increase in BMD from the Extension baseline at the ultradistal radius, 1/3 radius, and total radius was noted. The risk of upper limb fractures, including wrist, forearm, and humerus was significantly decreased by long-term denosumab treatment, which was associated with a complete reversal of bone loss when these patients received only calcium and vitamin D supplementation observed during the first 3 years of FREEDOM. Hence, the beneficial effects on both cortical and trabecular bone accruing over time of these drugs were suggested.