Osteoporosis: denosumab vs zoledronic acid linked to lower risk for cataract surgery

  • Lee H & al.
  • Drugs Aging
  • 6 Feb 2020

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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).

Limitations

  • Reliance on claims data.
  • Observational design.