Clinical Edge Journal Scan

Zoledronic acid treatment for osteoporosis modestly raises AFib risk


 

Key clinical point: Compared with denosumab, zoledronic acid (ZA) therapy for osteoporosis and possibly for malignancy-related bone disease is associated with modestly increased risk for incident atrial fibrillation (AFib) in the first year of treatment.

Major finding: In the osteoporosis cohort, the risk for AFib was higher with ZA vs. denosumab over 1 year (incidence rate [IR], 18.6 vs. 14.9 per 1,000 person-years; hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.04-1.50). In the malignancy cohort, a nonsignificant trend toward an increased risk was noted with ZA vs. denosumab (IR, 46.87 vs. 39.03 per 1,000 person-years; HR, 1.19; 95% CI, 1.00-1.43).

Study details: In this new-user, active comparator study, patients (age, 50 years or more) without arrhythmia or advanced kidney disease who initiated ZA were propensity score matched (1:1) to patients initiating denosumab in separate osteoporosis (n = 16,235 pairs) and malignancy (7,732 pairs) cohorts.

Disclosures: No study sponsor was identified. SC Kim received research grants to the Brigham and Women’s Hospital from Pfizer, AbbVie, Roche, and Bristol-Myers Squibb for unrelated studies. A close family member of SJ Cromer is employed by a Johnson & Johnson company. EW Yu received a research grant to the Massachusetts General Hospital from Amgen for unrelated studies. KM D'Silva and M Fischer reported no disclosures

Source: D'Silva KM et al. J Bone Miner Res. 2020 Nov 2. doi: 10.1002/jbmr.4174 .

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