Treatment of Osteoporosis With Anabolic Agents and the Risk of Primary Bone Cancers: A Study of 44,728 Patients Treated With Teriparatide and Abaloparatide.
Journal
The Journal of the American Academy of Orthopaedic Surgeons
ISSN: 1940-5480
Titre abrégé: J Am Acad Orthop Surg
Pays: United States
ID NLM: 9417468
Informations de publication
Date de publication:
15 05 2023
15 05 2023
Historique:
received:
18
11
2022
accepted:
06
02
2023
medline:
8
5
2023
pubmed:
14
3
2023
entrez:
13
3
2023
Statut:
ppublish
Résumé
Bone anabolic agents can benefit orthopaedic patients perioperatively and improve outcomes after fragility fractures. However, preliminary animal data raised concern for the potential development of primary bony malignancies after treatment with these medications. This investigation examined 44,728 patients older than 50 years who were prescribed teriparatide or abaloparatide and compared them with a matched control group to evaluate risk of primary bone cancer development. Patients younger than 50 years with a history of cancer or other risk factors of bony malignancy were excluded. A separate cohort of 1,241 patients prescribed an anabolic agent with risk factors of primary bone malignancy, along with 6,199 matched control subjects, was created to evaluate the effect of anabolic agents. Cumulative incidence and incidence rate per 100,000 person-years were calculated as were risk ratios and incidence rate ratios. The overall risk of primary bone malignancy development for risk factor-excluded patients in the anabolic agent-exposed group was 0.02%, compared with 0.05% in the nonexposed group. The incidence rate per 100,000 person-years was calculated at 3.61 for the anabolic-exposed patients and 6.46 for control subjects. A risk ratio of 0.47 ( P = 0.03) and incidence rate ratio of 0.56 ( P = 0.052) were observed for the development of primary bone malignancies in patients undergoing treatment with bone anabolic agents. Among high-risk patients, 5.96% of the anabolic-exposed cohort developed primary bone malignancies and 8.13% of nonexposed patients developed primary bone malignancy. The risk ratio was 0.73 ( P = 0.01), and the incidence rate ratio was 0.95 ( P = 0.67). Teriparatide and abaloparatide can safely be used for osteoporosis and orthopaedic perioperative management without increased risk of development of primary bone malignancy.
Identifiants
pubmed: 36913523
doi: 10.5435/JAAOS-D-22-01094
pii: 00124635-202305150-00006
doi:
Substances chimiques
Teriparatide
10T9CSU89I
Anabolic Agents
0
abaloparatide
AVK0I6HY2U
Bone Density Conservation Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
520-528Informations de copyright
Copyright © 2023 by the American Academy of Orthopaedic Surgeons.
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