AT A GLANCE

A new study published in the Annals of the Rheumatic Diseases suggests that romosozumab carries a lower risk of promoting osteoarthritis versus teriparatide in patients with osteoporosis.¹

In a target trial emulation study, authors Hatano et al. sought to investigate the risk of osteoarthritis associated with romosozumab compared to teriparatide in individuals with osteoporosis. 

For study purposes, eligible individuals who initiated romosozumab were compared with those who initiated teriparatide. The primary study outcome of interest was the incidence of osteoarthritis, while secondary outcomes included joint-specific osteoarthritis (knee, hip, and hand) at 1 year. Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between romosozumab and teriparatide users, with inverse probability of censoring weighting (IPCW) employed to account for informative censoring. Absolute risk reduction (ARR) and relative risk (RR) at 1 year were estimated using a weighted Kaplan–Meier estimator.

According to the authors, a total of 22,145 individuals were included in the study. Following IPTW/IPCW adjustment, romosozumab was found to be associated with a lower risk of osteoarthritis compared to teriparatide (ARR, 1.1%; RR, 0.79). Separately, joint-specific analyses yielded the following results: knee osteoarthritis: ARR, 0.8% and RR, 0.79; hip osteoarthritis: ARR, 0.2% and RR, 0.68; and hand osteoarthritis: ARR, 0.2% and RR, 0.61.

“Romosozumab was associated with a lower risk of osteoarthritis than teriparatide among individuals with osteoporosis, particularly for knee osteoarthritis. Similar trends were observed for hip and hand osteoarthritis; however, the differences were not significant,” conclude the authors.

Reference

1.     Hatano M, Sasabuchi Y, Okada A, et al. Osteoarthritis risk associated with romosozumab compared with teriparatide in individuals with osteoporosis: a target trial emulation study (online ahead of print July 4, 2025). Ann Rheum Dis.