Singer AJ, Liu J, Yan H, et al. - In this study, long-term persistence with anti-resorptive therapies in postmenopausal women was explored. Researchers designed a retrospective cohort study using administrative claims for women with data in the 100% Medicare osteoporosis sample who initiated (index date) denosumab, oral/intravenous (IV) bisphosphonate, or raloxifene between 2011 and 2014 and who had ≥ 1 year (zoledronic acid: 14 months) of pre-initiation medical/pharmacy coverage (baseline). They evaluated persistence from index date through end of continuous coverage, post-index evidence of censoring events (e.g., incident cancer), death, or end of study (December 31, 2015). They enrolled 318,419 oral bisphosphonate users (78% alendronate), 145,056 denosumab users, 48,066 IV bisphosphonate users, and 31,400 raloxifene users; mean age ranged from 75.5 years (raloxifene) to 78.5 years (denosumab). Using other anti-resorptive medications, including oral bisphosphonates, denosumab users persisted longer with therapy than women. As per the findings, early persistence may predict long-term persistence. The results demonstrate that overall persistence with osteoporosis medications is suboptimal and may impact fracture risk. Moreover, efforts to improve first year persistence are required.