Denosumab Increases Cardiovascular Risk in Dialysis-Dependent Patients

TUESDAY, Jan. 7, 2025 (HealthDay News) — For dialysis-dependent patients treated for osteoporosis, denosumab is associated with a greater preventive effect on fractures but an increased risk for major adverse cardiovascular events (MACE) compared with oral bisphosphonates, according to a study published online Jan. 7 in the Annals of Internal Medicine.

Soichiro Masuda, M.D., Ph.D., from Kyoto City Hospital in Japan, and colleagues examined the risk for cardiovascular events and fracture prevention effects with denosumab versus oral bisphosphonates in dialysis-dependent patients in an observational study using data from a Japanese administrative claims database. The study included 1,032 patients: 658 denosumab users and 374 oral bisphosphonate users.

The researchers found that for MACE, the weighted three-year risk difference was 8.2 percent, with a weighted three-year risk ratio of 1.36 (95 percent confidence interval, 0.99 to 1.87). For composite fractures, the weighted three-year risk difference was −5.3 percent, and the weighted three-year risk ratio was 0.55 (95 percent confidence interval, 0.28 to 0.93).

“Given the high risk for cardiovascular events associated with denosumab in dialysis-dependent patients, comparative effectiveness and safety of these medications should be confirmed in future studies,” the authors write.

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