Leslie WD, et al. - Researchers contrasted the use of anti-osteoporosis medication and fracture outcomes in women with vs without BMD monitoring receiving anti-osteoporosis medication using a registry-based cohort from the Province of Manitoba, Canada. They identified 4,559 women aged 40 years and older who received anti-osteoporosis therapy with serial BMD testing (monitoring) within 5 years (mean interval 3.2 years) and 4,559 propensity score-matched women without BMD monitoring. From a population-based retail pharmacy database, they evaluated anti-osteoporosis medication use over 5 years. A total of 1,225 women developed major osteoporotic fracture, including 382 with hip fractures during a median 10 years observation. In monitored vs not monitored women, days of medication use, medication persistence ratio, and treatment switching over 5 years were greater. More women in the monitored group persisted on treatment and more switched treatment at the end of 5 years, with switching behavior linked to an observed reduction in BMD. In the routine clinical practice setting, a possible role was found for BMD monitoring after initiating anti-osteoporosis therapy.