Denosumab therapy is associated with a reduced risk of clinically diagnosed rotator cuff tears: a multi-institutional real-world cohort study
Authors' conclusion
Denosumab therapy was associated with a reduced incidence of clinically diagnosed rotator cuff tears compared with both discontinuation and bisphosphonate therapy.
Study context
- Population
- Adults aged ≥50 years without prior rotator cuff tear or Paget diseasepropensity-matched
- Participants
- 61,952 / 61,952 / 113,949 / 113,949
- Exposure
- Continued DMAB vs single-dose DMAB; new DMAB vs new bisphosphonate users
- Continued denosumabn = 61,952
- Single-dosen = 61,952reference
- Denosumabn = 113,949
- Bisphosphonaten = 113,949reference
- Outcome
- Clinically diagnosed rotator cuff tears
Methodological detailsmulti-institutional, TriNetX global research network, propensity score matching, landmark analysis at 225 days, discontinuation design, active-comparator design
- Multi-institutional
- TriNetX global research network
- Propensity score matching
- Landmark analysis at 225 days
- Discontinuation design
- Active-comparator design
Main finding
As reported in the abstract
Clinically diagnosed RC tear
Continued denosumab vs Single-dose
Estimate (95% CI)
Hazard rationontraumatic RC tear; discontinuation analysis
0.42(0.37–0.48)
Denosumab vs Bisphosphonate
Estimate (95% CI)
Hazard ratioactive-comparator analysis
0.80(0.73–0.88)
Observational data: associations, not effects.
Further findings
Clinically diagnosed overall RC tears
- Similar trends were observed
Surgical outcomes
- Reduced in the discontinuation analysis; not significantly different in the active-comparator analysis
Original publication
Denosumab therapy is associated with a reduced risk of clinically diagnosed rotator cuff tears: a multi-institutional real-world cohort study. Osteoporos Int. Published 6 July 2026. doi:10.
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