Key clinical point : Delaying denosumab doses by more than 16 weeks is associated with an increased risk of vertebral fracture in patients with osteoporosis vs. on-time injections. However, evidence is insufficient to conclude that fracture risk is increased at other anatomical sites with a long delay.
Major finding : Compared with on-time injections (within 4 weeks after the recommended date), short delay (by 4-16 weeks) had a hazard ratio (HR) of 1.03 and long delay (by more than 16 weeks) an HR of 1.44 ( P for trend = .093) for composite fracture. For vertebral fractures, short delay had an HR of 1.48 and long delay an HR of 3.91 ( P for trend = .005).
Study details : This U.K. population-based cohort study included 2,594 patients (age, 45 years or older) who initiated denosumab therapy for osteoporosis.
Disclosures: The study was supported by a grant from the National Institutes of Health and by the internal resources from the National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation (Beijing) and Xiangya Hospital, Central South University. The authors declared no conflicts of interest in relation to the subject of the study. Three of the authors reported receiving grants from 1 or more pharma companies, outside the submitted work.
Source: Lyu H et al. Ann Intern Med. 2020 Jul 28. doi: 10.7326/M20-0882 .