Denosumab在抗骨质疏松治疗中的初始使用者在初级保健实践中与阿仑膦酸盐相比,与2型糖尿病的风险较低有关。
目的:已经提出了骨代谢与糖耐量之间的联系。核因子κB受体激活剂配体(RANKL)信号传导的下调改善了葡萄糖代谢。Denosumab,抗RANKL的人单克隆抗体,可能与2型糖尿病(T2D)的风险较低有关。目的是比较使用地诺塞马或阿仑膦酸钠的初级保健患者中T2DM的发生率。这是骨质疏松症的一线疗法。阿仑膦酸盐作为比较物增强了两个队列的可比性。
方法:IQVIA疾病分析仪由一般和专业实践的代表性小组(德国)组成。在没有糖尿病史且年龄≥45岁的接受地诺舒马或阿仑膦酸钠治疗(2010-2021)的患者中进行了一项新用户比较研究。估计了T2DM的发病率(每1000人年)和Cox比例风险比(HR;95CI)。
结果:该队列包括3,354名denosumab(年龄:75岁;女性:87%)和27,068名阿仑膦酸钠(76岁;86%)使用者。总的来说,1,038人在54,916人年期间发展了T2D。每1000人年的T2DM发病率为11.9(9.5-14.4),对于阿仑膦酸盐使用者为20.1(18.8-21.3),分别。与阿仑膦酸盐相比,Denosumab与T2DM的风险降低相关。调整年龄,性别,指数年,访问,肥胖,合并症和他汀类药物(HR:0.73;0.58-0.89)。
结论:在这项常规实践中看到的老年患者的比较研究中,与阿仑膦酸钠相比,地诺塞马与患T2DM的风险较低相关。
Denosumab initiation is related to a lower risk of type 2 diabetes than alendronate in anti-osteoporotic treatment-naïve users in primary care practices.
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: In this comparative study of older patients seen in routine practices, denosumab was associated with a lower risk of developing T2DM than alendronate.