Denosumab may reduce the risk of developing diabetes, according to recent study results published in . JAMA network open. Patients with osteoporosis who continued two doses of denosumab had a significantly lower risk of developing diabetes than those who did not continue treatment after the first dose.
“These findings may help physicians select appropriate anti-osteoporosis drugs for patients with osteoporosis, while also considering drugs associated with lower diabetes risk,” the authors wrote.
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Denosumab is a humanized monoclonal antibody against receptor activator of nuclear factor kappa B ligand (RANKL) used to treat osteoporosis, a condition associated with loss of bone density and strength. Osteoporosis affects many older people around the world.
A growing body of research is highlighting the link between bone health and glucose metabolism. Prevention of diabetes may benefit bone health as well as metabolic health, as diabetes can worsen bone fragility and increase other risks in patients with osteoporosis.
Researchers in Taiwan conducted a large national propensity score matched cohort study to evaluate the effectiveness of denosumab in reducing the incidence of diabetes in patients with osteoporosis.
This study included 68,510 Taiwanese participants (average [SD] Age, 77.7 years old [9.8] Year. 57,762 [84.3%] woman). Researchers evaluated 34,255 patients who started and continued denosumab treatment and 34,255 patients who started denosumab treatment but discontinued it after the first dose. Participants were followed for an average of 1.9 years.
In the comparison (single-dose) group, 3,220 participants developed diabetes, compared with 2,016 patients in the two-dose group (incidence rate, 35.9 vs. 43.6 per 1000 person-years). This indicates that continued denosumab treatment may reduce risk. Diabetes incidence over single dose (HR, 0.84; 95% CI, 0.78-0.90).
Additionally, age-stratified analyzes showed that adults 65 years and older were particularly likely to benefit from denosumab given two doses compared to the first single dose (HR, 0.80; 95% CI, 0.75-0.85). Treatment was also shown to reduce the risk of developing diabetes in both men and women (HR, 0.85; 95% CI, 0.73 to 0.97 and HR, 0.81; 95% CI, 0.76 to 0.86, respectively). Comorbidities influenced the ability to reduce diabetes risk.
Although there is no specific explanation as to why denosumab reduces diabetes risk, previous research suggests that lowering RANKL may reduce inflammation associated with diabetes and insulin resistance. I am. Loss of β-cell replication may also be associated with diabetes, so using drugs that act against RANKL may promote β-cell proliferation and reduce the risk of diabetes.
Limitations of this study include the use of claims-based data. Residual confounders and differential censoring remain. Indirectly assess the occurrence of diabetes. and produce findings that may not be generalizable to other races, ethnicities, or countries.
“This study provides a basic background for future prospective studies or randomized clinical trials to validate findings regarding the association between denosumab use and reduced diabetes risk,” the authors wrote. There is.
reference
Huang H, Chuang AT, Liao T, et al. Risk of diabetes in patients treated for osteoporosis with denosumab. JAMA Net Open. 2024;7(2):e2354734. doi:10.1001/jamanetworkopen.2023.54734
