Denosumab and Risk of Type 2 Diabetes Risk Among Patients With Osteoporosis: A Retrospective Cohort Study
Cheng-Han Han1, Yu-Chen Tsai2, Shiow-Ing Wang3
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Summary
Intravenous bisphosphonates significantly reduced the risk of developing type 2 diabetes mellitus (T2D) in osteoporosis patients compared to denosumab. This suggests potential metabolic advantages for bisphosphonates in managing osteoporosis.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Osteoporosis is a common condition requiring effective treatment.
- Type 2 diabetes mellitus (T2D) is a growing public health concern.
- Understanding drug-related risks for T2D is crucial for patient care.
Purpose of the Study:
- To compare the incidence of new-onset type 2 diabetes mellitus (T2D) between patients receiving intravenous (IV) bisphosphonates and denosumab for osteoporosis.
- To evaluate the long-term risk differences associated with these osteoporosis medications.
Main Methods:
- A retrospective cohort study utilized the TriNetX database (2016-2024).
- Patients initiating IV bisphosphonates (zoledronic acid, ibandronate) or denosumab were propensity score matched (1:1).
- Incident T2D was identified by ICD-10 code E11 or antidiabetic medication initiation; hazard ratios (HRs) were calculated.
Main Results:
- After matching, 20,735 patients were in each cohort.
- IV bisphosphonates were associated with a significantly lower risk of T2D compared to denosumab at 1, 3, 5, and 7 years (HRs ranging from 0.745 to 0.821, all p<0.001).
- Consistent risk reduction was observed across subgroups including females, individuals aged ≥65 years, Whites, and Black or African Americans.
Conclusions:
- Intravenous bisphosphonates demonstrate a lower risk of incident T2D in osteoporosis patients compared to denosumab.
- These findings indicate potential metabolic benefits of IV bisphosphonates.
- Further prospective studies are recommended to confirm these observations.
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