- Denosumab for osteoporosis is associated with 9% fewer cases of cataract surgery than zoledronic acid, but no relatively greater improvement in dry and wet age-related macular degeneration.
Why this matters
- This study is 1 of the first head-to-head comparisons of denosumab vs zoledronic acid for ocular effects.
- A previous study suggested that bisphosphonates such as zoledronic acid trigger a cascade of inflammatory cytokines leading to ocular inflammation.
- A prospective cohort study of ocular manifestations in denosumab initiators (n=50,821) vs zoledronic acid initiators (n=67,471) in the first 365 days of use in patients with osteoporosis (age ≥50 years).
- Results were based on pooling of claims data of 2 commercial insurers (Optum and MarketScan) from 2010 to 2015.
- Funding: Brigham and Women's Hospital.
- Denosumab was associated with 9% fewer claims for cataract surgery than zoledronic acid (HR, 0.91; 95% CI, 0.85-0.98), according to a propensity score-weighted analysis.
- No differences seen between groups for:
- Wet age-related macular degeneration: HR, 1.29 (95% CI, 0.99-1.7).
- Dry age-related macular degeneration: HR, 1.03 (95% CI, 0.98-1.09).
- Reliance on claims data.
- Observational design.