Alendronate to denosumab in OVX monkeys Denosumab further reduced bone remodelling with a superior increase in vertebral bone strength Mineralising surfaces (12 months) Vehicle ALN ALN-Dmab 5 10 15 20 VEH-Dmab Dmab Peak load : L5-L6 vertebral trabecular core MS/ BS (%) * 100 200 300 Peak load (N) Vehicle Vehicle to Dmab ALN ALN to Dmab Dmab * ^ * * * * * * * ^ ^ * * Osteoclast surfaces (12 months) 0.0 0.5 1.0 1.5 2.0 Oc.S/ BS (%) ^ ^ ^ ^ ^ ^ * * * * * * * * * Iliac Crest L2 Vertebrae Proximal Tibia Mean ± SEM; *p < 0.05 vs vehicle; ^p < 0.05 vs ALN Ominsky MS, et al.