ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026
Decreased incidence of shoulder arthroplasty in patients prescribed anti-resorptive therapy for osteoporosis.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
rationaleEvaluate whether osteoporosis treatment influences osteoarthritis (OA) progression, using total shoulder arthroplasty (TSA) incidence as a proxy. MAIN
resultOsteoporosis treatment was associated with lower TSA incidence compared with untreated patients. SIGNIFICANCE: Findings may clarify the relationship between osteoporosis management and shoulder OA progression, informing patient counseling and management. PURPOSE: We evaluated in this study the impact of osteoporosis (OP) medications in patients with shoulder osteoarthritis (OA) and compared the incidence of total shoulder arthroplasty (TSA) in treated versus untreated OP patients. We hypothesized that OP medications would lead to a decreased progression of OA, manifesting as a decreased incidence of TSA.
methodsUsing the TriNetX database, patients with OP diagnosed with primary shoulder OA were identified. Propensity score matching (1:1) was performed to control for relevant comorbidities, creating two cohorts of patients receiving antiresorptive therapy (denosumab or bisphosphonates) and untreated OP controls (n = 4,163 per group). A sub-analysis was conducted using similarly matched cohorts comparing denosumab versus bisphosphonates (n = 844 per group). The outcome of interest was the 5-year incidence of TSA in addition to TSA-free survival. Significance was set at p < 0.05.
resultsThe matched cohorts in both analyses were properly balanced. Patients receiving antiresorptive therapy demonstrated a lower 5-year incidence of TSA compared with untreated controls (1.80% vs 2.60%, p = 0.014), which was confirmed on Kaplan-Meier survival analysis (Hazard ratio HR 0.69, 95% CI 0.52-0.93). In contrast, no significant differences were observed between patients receiving denosumab and those receiving bisphosphonates in terms of 5-year TSA incidence (1.8% vs 1.4%, p = 0.561) or on Kaplan-Meier analysis (HR 1.25, 95% CI 0.58-2.67).
conclusionOP medications in patients with shoulder OA were associated with a reduced incidence of TSA. No differences were observed between denosumab and bisphosphonates. These findings suggest a potential role for antiresorptive therapy in delaying progression of shoulder OA.
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