Denosumab significantly delayed the time to first on-study HCM , representing a @ % reduction in the hazard ratio ( HR ) compared with zoledronic acid ( HR , @ ; @ % confidence interval ( CI ) : @-@ @ ; P = @ ) and reduced the risk of developing recurrent HCM ( time to first and subsequent on-study HCM ) by @ % ( rate ratio , @ ; @ % CI : @-@ @ ; P = @ ) .