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This retrospective study aimed to assess the comparability of postmenopausal women treated with osteoporosis medications with various mechanisms of action. Negative control outcomes (NCOs) were used to assess comparability between treatment groups in effectiveness studies. Propensity scores were used to match denosumab patients 1:1 to comparators. Four non-fracture NCOs and three early fracture NCOs were assessed over 1-year and 3-month follow-up periods, respectively. Among new users, new switchers, and in the historical fracture subgroup, no meaningful differences were observed in the cumulative incidence of the 7 NCOs comparing denosumab to zoledronic acid. This study can assist in selecting appropriate comparator groups for future comparability research using real-world data.
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