Denosumab may lower risk of type 2 diabetes in adults with osteoporosis

China: A new study published in the BMJ: British Medical Journal suggests that denosumab, a medication used to treat osteoporosis, may have an added benefit for glucose metabolism compared with oral bisphosphonates.

The study aimed to assess the effect of denosumab versus oral bisphosphonates on the risk of type 2 diabetes in persons with osteoporosis.

The study involved the emulation of a randomized target trial using electronic health records. The study analyzed 4301 new users of denosumab from the IQVIA Medical Research Data primary care database in the United Kingdom from 1995 to 2021.

The participants included were adults aged 45 and over who were using denosumab or an oral bisphosphonate for osteoporosis. The main outcome was the occurrence of type 2 diabetes, as determined by diagnostic codes.

The study revealed the following clinical takeaways:

1. The incidence rate of type 2 diabetes in denosumab users was 5.7 per 1000 person-years.

2. The incidence rate of type 2 diabetes in oral bisphosphonate users was 8.3 per 1000 person-years.

3. Initiation of denosumab was associated with a reduced risk of type 2 diabetes.

4. Participants with prediabetes appeared to benefit more from denosumab compared with oral bisphosphonate.

5. Those with a body mass index ≥30 also appeared to benefit more from denosumab.

The study’s lead author Houchen Lyu added that “While this study provides important insights, further research is needed to confirm these findings and to investigate the underlying mechanisms. They also caution that the study was observational in nature, and therefore cannot establish causality.”

These findings suggest that denosumab may have potential benefits beyond its primary use in treating osteoporosis and could be an important consideration for healthcare providers treating patients at risk of both osteoporosis and type 2 diabetes.

Reference:

Lyu H., Zhao S., Zhang L., Wei J., Li X., et al.; Denosumab and incidence of type 2 diabetes among adults with osteoporosis: population based cohort study; BMJ 2023;381:e073435; doi: https://doi.org/10.1136/bmj-2022-073435