Denosumab, for osteoporosis, reduces the incidence of type 2 diabetes, risk of foot ulceration and all‐cause mortality in adults, compared with bisphosphonates: An analysis of real‐world, cohort data, with a systematic review and meta‐analysis
Pooled result · Incident T2DResult — go to the resultHazard ratio 0.83 95% CI 0.78–0.88Authors' conclusion
This is the largest cohort study to show that denosumab treatment is associated with a reduced RR of incident T2D, as well as an associated reduced RR of all-cause mortality and microvascular complications, findings that may influence guideline development in the treatment of osteoporosis, particularly in patients who are at a high risk of T2D.
Study context
- Population
- Patients without baseline T2D or cancer prescribed denosumab or bisphosphonates, TriNetX global federated database, 83 healthcare organizations45,851 per cohort after matching
- Participants
- 331,375 patients
- Comparison
- Denosumab vs bisphosphonates
- Denosumabn = 45,854
- Bisphosphonatesn = 285,521reference
- Outcome
- Incident T2D
- Follow-up
- 5 years
Methodological detailspropensity-score matched (1:1), federated database (TriNetX), 83 healthcare organizations, random-effects meta-analysis
- Propensity-score matched (1:1)
- Federated database (TriNetX)
- 83 healthcare organizations
- Random-effects meta-analysis
Pooled result
As reported in the abstract
Hazard ratio
0.83
95% CI 0.78–0.88
Denosumabvs Bisphosphonates
HR 0.83 (95% CI 0.78–0.88)
Further pooled results
All-cause mortality (secondary analysis, patients with T2D)
- Significant risk reduction in all-cause mortality
- 0.79 [0.72-0.87]
Foot ulceration (secondary analysis, patients with T2D)
- Significant risk reduction in foot ulceration
- 0.67 [0.53-0.86]
Incident T2D, meta-analysis of 4 studies (3 observational, 1 RCT)
- Reduced RR (95% CI) for incident T2D with denosumab
- 0.83 [0.79-0.87]
- I2
- 10.76%
- Random-effects meta-analysis
Original publication
Denosumab, for osteoporosis, reduces the incidence of type 2 diabetes, risk of foot ulceration and all‐cause mortality in adults, compared with bisphosphonates: An analysis of real‐world, cohort data, with a systematic review and meta‐analysis. Diabetes Obes Metab. Published 20 June 2024. doi:10.
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