Denosumab treatment and infection risks in patients with osteoporosis: propensity score matching analysis of a national-wide population-based cohort study
IntroductionDenosumab demonstrates efficacy in reducing the incidence of hip, vertebral, and nonvertebral fractures in postmenopausal women with osteoporosis. We present a population-based national cohort study to evaluate the infection risks in patients with osteoporosis after long-term denosumab t...
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1182753/full |
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| author | Shih-Ting Huang Shih-Ting Huang Shih-Ting Huang Shih-Ting Huang Ting-Fang Chiu Ting-Fang Chiu Ting-Fang Chiu Ting-Fang Chiu Chih-Wei Chiu Yu-Nong Kao Yu-Nong Kao I-Kang Wang I-Kang Wang Chi-Tzung Chang Chi-Yuan Li Chung-Shu Sun Cheng-Li Lin Cheng-Li Lin Tung-Min Yu Tung-Min Yu Tung-Min Yu Tung-Min Yu Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao |
| author_facet | Shih-Ting Huang Shih-Ting Huang Shih-Ting Huang Shih-Ting Huang Ting-Fang Chiu Ting-Fang Chiu Ting-Fang Chiu Ting-Fang Chiu Chih-Wei Chiu Yu-Nong Kao Yu-Nong Kao I-Kang Wang I-Kang Wang Chi-Tzung Chang Chi-Yuan Li Chung-Shu Sun Cheng-Li Lin Cheng-Li Lin Tung-Min Yu Tung-Min Yu Tung-Min Yu Tung-Min Yu Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao |
| author_sort | Shih-Ting Huang |
| collection | DOAJ |
| description | IntroductionDenosumab demonstrates efficacy in reducing the incidence of hip, vertebral, and nonvertebral fractures in postmenopausal women with osteoporosis. We present a population-based national cohort study to evaluate the infection risks in patients with osteoporosis after long-term denosumab therapy.MethodsWe used the Taiwan National Health Insurance Research Database (NHIRD) to identify patients with osteoporosis. The case cohort comprised patients treated with denosumab. Propensity score (PS) matching was used to select denosumab nonusers for the control cohort. The study period was between August 2011 and December 2017. Our study comprised 30,106 pairs of case and control patients.ResultsPatients receiving denosumab therapy had high risks of the following infections: pneumonia and influenza (adjusted hazard ratio [aHR]: 1.33; 95% confidence interval [CI]: 1.27 -1.39), urinary tract infection (aHR: 1.36; 95% CI:1.32 -1.40), tuberculosis (aHR: 1.60; 95% CI: 1.36 -1.87), fungal infection (aHR: 1.67; 95% CI:1.46 -1.90), candidiasis (aHR: 1.68; 95% CI: 1.47 -1.93), herpes zoster infection (aHR: 1.27; 95% CI: 1.19 -1.35), sepsis (aHR: 1.54; 95% CI:1.43 -1.66), and death (aHR: 1.26; 95% CI: 1.20 -1.32). However, the longer the duration of denosumab treatment, the lower the risk patients had of developing infections.DiscussionDenosumab therapy is associated with a higher infection risk at the early periods of treatment. Nevertheless, the risk attenuates significantly after the 2nd year of therapy. Clinicians should closely monitor infection status in patients with osteoporosis during the initial stages of denosumab therapy. |
| first_indexed | 2024-03-13T10:26:53Z |
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| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-13T10:26:53Z |
| publishDate | 2023-05-01 |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-795ece80c0534a1787267e7de4412f392023-05-19T06:04:56ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-05-011410.3389/fendo.2023.11827531182753Denosumab treatment and infection risks in patients with osteoporosis: propensity score matching analysis of a national-wide population-based cohort studyShih-Ting Huang0Shih-Ting Huang1Shih-Ting Huang2Shih-Ting Huang3Ting-Fang Chiu4Ting-Fang Chiu5Ting-Fang Chiu6Ting-Fang Chiu7Chih-Wei Chiu8Yu-Nong Kao9Yu-Nong Kao10I-Kang Wang11I-Kang Wang12Chi-Tzung Chang13Chi-Yuan Li14Chung-Shu Sun15Cheng-Li Lin16Cheng-Li Lin17Tung-Min Yu18Tung-Min Yu19Tung-Min Yu20Tung-Min Yu21Chia-Hung Kao22Chia-Hung Kao23Chia-Hung Kao24Chia-Hung Kao25Division of Nephrology, Taichung Veterans General Hospital, Taichung, TaiwanGraduate Institute of Public Health, China Medical University, Taichung, TaiwanDepartment of Internal Medicine, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanDepartment of Pediatrics, Taipei City Hospital Zhongxiao Branch, Taipei, TaiwanDepartment of Health and Welfare, University of Taipei, Taipei, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanGraduate Institute of Business Administration, Fu Jen Catholic University, New Taipei, TaiwanDepartment of Nephrology, Kaohsiung Medical University Baccalaureate Medicine, Kaohsiung, TaiwanDivision of Nephrology, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Internal Medicine, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan0Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan0Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Pediatrics, Taipei City Hospital Zhongxiao Branch, Taipei, TaiwanDepartment of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan1Management Office for Health Data, China Medical University Hospital, Taichung, TaiwanDivision of Nephrology, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Internal Medicine, College of Medicine, China Medical University, Taichung, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan0Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan0Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan2Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan3Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan4Artificial Intelligence Center, China Medical University Hospital, Taichung, TaiwanIntroductionDenosumab demonstrates efficacy in reducing the incidence of hip, vertebral, and nonvertebral fractures in postmenopausal women with osteoporosis. We present a population-based national cohort study to evaluate the infection risks in patients with osteoporosis after long-term denosumab therapy.MethodsWe used the Taiwan National Health Insurance Research Database (NHIRD) to identify patients with osteoporosis. The case cohort comprised patients treated with denosumab. Propensity score (PS) matching was used to select denosumab nonusers for the control cohort. The study period was between August 2011 and December 2017. Our study comprised 30,106 pairs of case and control patients.ResultsPatients receiving denosumab therapy had high risks of the following infections: pneumonia and influenza (adjusted hazard ratio [aHR]: 1.33; 95% confidence interval [CI]: 1.27 -1.39), urinary tract infection (aHR: 1.36; 95% CI:1.32 -1.40), tuberculosis (aHR: 1.60; 95% CI: 1.36 -1.87), fungal infection (aHR: 1.67; 95% CI:1.46 -1.90), candidiasis (aHR: 1.68; 95% CI: 1.47 -1.93), herpes zoster infection (aHR: 1.27; 95% CI: 1.19 -1.35), sepsis (aHR: 1.54; 95% CI:1.43 -1.66), and death (aHR: 1.26; 95% CI: 1.20 -1.32). However, the longer the duration of denosumab treatment, the lower the risk patients had of developing infections.DiscussionDenosumab therapy is associated with a higher infection risk at the early periods of treatment. Nevertheless, the risk attenuates significantly after the 2nd year of therapy. Clinicians should closely monitor infection status in patients with osteoporosis during the initial stages of denosumab therapy.https://www.frontiersin.org/articles/10.3389/fendo.2023.1182753/fulldenosumabimmunityRANKL inhibitionT-cellosteoporosis |
| spellingShingle | Shih-Ting Huang Shih-Ting Huang Shih-Ting Huang Shih-Ting Huang Ting-Fang Chiu Ting-Fang Chiu Ting-Fang Chiu Ting-Fang Chiu Chih-Wei Chiu Yu-Nong Kao Yu-Nong Kao I-Kang Wang I-Kang Wang Chi-Tzung Chang Chi-Yuan Li Chung-Shu Sun Cheng-Li Lin Cheng-Li Lin Tung-Min Yu Tung-Min Yu Tung-Min Yu Tung-Min Yu Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao Denosumab treatment and infection risks in patients with osteoporosis: propensity score matching analysis of a national-wide population-based cohort study Frontiers in Endocrinology denosumab immunity RANKL inhibition T-cell osteoporosis |
| title | Denosumab treatment and infection risks in patients with osteoporosis: propensity score matching analysis of a national-wide population-based cohort study |
| title_full | Denosumab treatment and infection risks in patients with osteoporosis: propensity score matching analysis of a national-wide population-based cohort study |
| title_fullStr | Denosumab treatment and infection risks in patients with osteoporosis: propensity score matching analysis of a national-wide population-based cohort study |
| title_full_unstemmed | Denosumab treatment and infection risks in patients with osteoporosis: propensity score matching analysis of a national-wide population-based cohort study |
| title_short | Denosumab treatment and infection risks in patients with osteoporosis: propensity score matching analysis of a national-wide population-based cohort study |
| title_sort | denosumab treatment and infection risks in patients with osteoporosis propensity score matching analysis of a national wide population based cohort study |
| topic | denosumab immunity RANKL inhibition T-cell osteoporosis |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1182753/full |
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