Authors’ reply to Laurent

Laurent raises several thoughtful questions regarding our sub-cohort focused on the use of denosumab in castration sensitive prostate cancer.12In summary, the question is whether our methods distinguished use of denosumab for prevention of osteoporotic fractures (which would be appropriate) versus prevention of skeletal related events (SREs) (which would not be recommended).Our methods did account for this consideration—however, we inadvertently failed to describe this important step in our manuscript methods. The outcome in this cohort was not any claim for denosumab (as we stated), but rather any claim for denosumab with a number of billed units of ≥120 mg (the SRE dose).In addition, even in the absence of this step, it is unlikely that denosumab use for osteoporotic fracture prevention would have made a meaningful impact on outcome incidence. As previously reported, after excluding any patient who had recent or incident billed claims for osteoporosis, osteopenia, hypercalcemia, or bone fracture (as…
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