Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf'm Hennekamp 65, Düsseldorf, 40225, Germany.
German Center for Diabetes Research, Partner Düsseldorf, Munich-Neuherberg, Germany.
Osteoporos Int. 2024 Dec;35(12):2099-2106. doi: 10.1007/s00198-024-07182-6. Epub 2024 Jul 24.
Denosumab initiation is related to a lower risk of type 2 diabetes than alendronate in anti-osteoporotic treatment-naïve users in primary care practices.
Links have been suggested between bone metabolism and glucose tolerance. Downregulation of the receptor activator of nuclear factor κ B ligand (RANKL) signaling improves glucose metabolism. Denosumab, a human monoclonal antibody against RANKL, may be associated with a lower risk of type 2 diabetes (T2D). The aim was to compare incidence rates of T2DM in primary care patients initiating denosumab or alendronate, which is a first-line therapy of osteoporosis. Alendronate as comparator enhances comparability of the two cohorts.
The IQVIA Disease Analyzer comprises a representative panel of general and specialist practices (Germany). A new-user comparative study was conducted among patients with denosumab or alendronate treatment (2010-2021) without history of diabetes and age ≥ 45 years. Incidence rates (per 1,000 person-years) and Cox proportional hazard ratios (HR; 95%CI) for T2DM were estimated.
The cohorts consisted of 3,354 denosumab (age: 75 years; women: 87%) and 27,068 alendronate (76 years; 86%) users. Overall, 1,038 persons developed T2D during 54,916 person-years. T2DM incidence rates per 1,000 person-years were 11.9 (9.5-14.4) for denosumab and 20.1 (18.8-21.3) for alendronate users, respectively. Denosumab was associated with a reduced risk of T2DM compared to alendronate, adjusting for age, sex, index year, visits, obesity, comorbidities and statins (HR: 0.73; 0.58-0.89).
In this comparative study of older patients seen in routine practices, denosumab was associated with a lower risk of developing T2DM than alendronate.
在初级保健实践中，与阿仑膦酸盐相比，地舒单抗的起始治疗与 2 型糖尿病风险降低相关。
有研究提示骨代谢和葡萄糖耐量之间存在关联。核因子κ B 配体（RANKL）信号的下调可改善葡萄糖代谢。地舒单抗是一种针对 RANKL 的人源单克隆抗体，可能与 2 型糖尿病（T2DM）风险降低相关。本研究旨在比较开始使用地舒单抗或阿仑膦酸盐治疗的初级保健患者的 T2DM 发生率，阿仑膦酸盐是骨质疏松症的一线治疗药物。将阿仑膦酸盐作为对照药物可增强两组间的可比性。
IQVIA 疾病分析器包含一般和专科实践的代表性样本（德国）。对 2010 年至 2021 年期间无糖尿病病史且年龄≥45 岁的地舒单抗或阿仑膦酸盐治疗患者（n=60,602）进行了新使用者的比较研究。估计 T2DM 的发病率（每 1000 人年）和 Cox 比例风险比（HR；95%CI）。
两个队列分别包括 3354 例地舒单抗（年龄：75 岁；女性：87%）和 27068 例阿仑膦酸盐（76 岁；86%）使用者。共有 1038 人在 54916 人年中发生了 T2D。每 1000 人年的 T2DM 发病率分别为地舒单抗组 11.9（9.5-14.4）和阿仑膦酸盐组 20.1（18.8-21.3）。在地舒单抗与阿仑膦酸盐比较中，调整年龄、性别、指数年、就诊次数、肥胖、合并症和他汀类药物后，地舒单抗发生 T2DM 的风险降低（HR：0.73；0.58-0.89）。
在这项常规实践中对老年患者进行的比较研究中，与阿仑膦酸盐相比，地舒单抗发生 T2DM 的风险较低。
