Denosumab Adherence Preference Satisfaction Study

Inclusion Criteria

• Ambulatory postmenopausal women based on medical history
• > or = 55 years of age at the start of screening
• Screening bone mineral density (BMD) values (g/cm²), at the lumbar spine OR femoral neck OR total hip that occur within the specified ranges based on the particular scanner that is used. At least 2 lumbar vertebrae must be evaluable by Dual X-ray Absorptiometry (DXA), or at least one hip must be evaluable by DXA
• Provide written informed consent before any study specific procedure is performed.

Exclusion Criteria

• Any disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures
• Hyper- or hypothyroidism; however, stable subjects, in the investigator's opinion, on thyroid hormone replacement therapy are allowed
• Current hyper- or hypoparathyroidism
• Current hypo- or hyper calcemia based on the central laboratory reference ranges for albumin-adjusted serum calcium
• Rheumatoid arthritis, Paget's disease, Cushing's disease, hyperprolactinemia, or cirrhosis of the liver
• Any metabolic bone disease, e.g. osteomalacia or osteogenesis imperfecta, which may interfere with the interpretation of the findings
• Any symptomatic vertebral fracture within 3 months prior to screening
• Previous participation in clinical trials with denosumab
• Vitamin D deficiency [25(OH) vitamin D level < 20 ng/mL (<49.9 nmol/L)]
• Contraindicated to alendronate therapy; contraindications for alendronate therapy include:
• Abnormalities of the esophagus, which delay esophageal emptying such as stricture or achalasia.
• Inability to stand or sit upright for at least 30 minutes.
• Hypersensitivity to alendronate (ALN) or other constituents of ALN tablets.
• Any known prior bisphosphonate use
• Currently enrolled in or has not yet completed at least 1 month since ending other investigational device or drug trail (s), or subject is receiving other investigational agent(s).