Judith EG, Daniel L, John-Patrik B, et al. - Osteoporosis treatment using denosumab was associated with a higher risk of developing osteonecrosis of the jaw (ONJ) vs treatment using bisphosphonates (BPs) (hazard ratio 3.49, 95% CI: 1.16 to 10.47).

• A total of 3,068 patients with osteoporosis (median age 69 years) with at least one dual-energy X-ray absorptiometry and treated with BPs or denosumab for a cumulative span of 11,101 and 4,236 patient-years, respectively, were included.

• There were 17 cases of ONJ; 12 in those taking denosumab at the time of ONJ diagnosis and five in those on oral or intravenous BP therapy.

• Per 10,000 observed patient-years, ONJ incidence was 28.3 and 4.5 in patients receiving denosumab or BPs, respectively, providing a rate ratio of 6.3 (95% CI: 2.1 to 22.8).

• Previous BP treatment prior to switching to denosumab could represent an additional risk factor for ONJ occurrence.