Key clinical point: The prevalence of periapical lesions is significantly higher in patients with vs. without osteoporosis. Patients treated with bisphosphonates (BPs) have a lower prevalence of periapical lesions.

Major finding: The prevalence of periapical lesions in patients with osteoporosis was significantly higher compared with the general patient population in the hospital (odds ratio, 3.36; P less than .0001). Treatment with BPs was associated with a lower prevalence of periapical lesions than no treatment with BPs (P less than.0001).

Study details: Analysis of data from 1,644,953 individuals, including admitted patients as well as outpatients.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Katz J et al. J Endod. 2020 Oct 28. doi: 10.1016/j.joen.2020.10.019.

Key clinical point: The prevalence of periapical lesions is significantly higher in patients with vs. without osteoporosis. Patients treated with bisphosphonates (BPs) have a lower prevalence of periapical lesions.

Major finding: The prevalence of periapical lesions in patients with osteoporosis was significantly higher compared with the general patient population in the hospital (odds ratio, 3.36; P less than .0001). Treatment with BPs was associated with a lower prevalence of periapical lesions than no treatment with BPs (P less than.0001).

Study details: Analysis of data from 1,644,953 individuals, including admitted patients as well as outpatients.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Katz J et al. J Endod. 2020 Oct 28. doi: 10.1016/j.joen.2020.10.019.

Key clinical point: The prevalence of periapical lesions is significantly higher in patients with vs. without osteoporosis. Patients treated with bisphosphonates (BPs) have a lower prevalence of periapical lesions.

Major finding: The prevalence of periapical lesions in patients with osteoporosis was significantly higher compared with the general patient population in the hospital (odds ratio, 3.36; P less than .0001). Treatment with BPs was associated with a lower prevalence of periapical lesions than no treatment with BPs (P less than.0001).

Study details: Analysis of data from 1,644,953 individuals, including admitted patients as well as outpatients.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Katz J et al. J Endod. 2020 Oct 28. doi: 10.1016/j.joen.2020.10.019.

Key clinical point: Patients with impaired fasting glucose (IFG) and diabetes mellitus (DM) have a lower risk for incident osteoporosis.

Major finding: The risk of osteoporosis significantly decreased (P less than .001 for all) above the fourth quartile of fasting glucose levels in men and above the third quartile in women compared with the first quartile. The risk of osteoporosis was significantly lower (P less than .001 for all) with IFG (men: hazard ratio [HR], 0.84; women: HR, 0.93) and DM (men: HR, 0.77; women: HR, 0.75) compared with the normal glucose group.

Study details: The data come from a retrospective study of 96,626 patients.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Park SK et al. Bone. 2020 Oct 21. doi: 10.1016/j.bone.2020.115690.

Key clinical point: Patients with impaired fasting glucose (IFG) and diabetes mellitus (DM) have a lower risk for incident osteoporosis.

Major finding: The risk of osteoporosis significantly decreased (P less than .001 for all) above the fourth quartile of fasting glucose levels in men and above the third quartile in women compared with the first quartile. The risk of osteoporosis was significantly lower (P less than .001 for all) with IFG (men: hazard ratio [HR], 0.84; women: HR, 0.93) and DM (men: HR, 0.77; women: HR, 0.75) compared with the normal glucose group.

Study details: The data come from a retrospective study of 96,626 patients.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Park SK et al. Bone. 2020 Oct 21. doi: 10.1016/j.bone.2020.115690.

Key clinical point: Patients with impaired fasting glucose (IFG) and diabetes mellitus (DM) have a lower risk for incident osteoporosis.

Major finding: The risk of osteoporosis significantly decreased (P less than .001 for all) above the fourth quartile of fasting glucose levels in men and above the third quartile in women compared with the first quartile. The risk of osteoporosis was significantly lower (P less than .001 for all) with IFG (men: hazard ratio [HR], 0.84; women: HR, 0.93) and DM (men: HR, 0.77; women: HR, 0.75) compared with the normal glucose group.

Study details: The data come from a retrospective study of 96,626 patients.

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Park SK et al. Bone. 2020 Oct 21. doi: 10.1016/j.bone.2020.115690.

Key clinical point: Psoriasis was associated with an elevated risk of osteoporosis in individuals aged 40 years or older.

Major finding: In study 1 (a follow-up study), the psoriasis group had a significantly higher risk of osteoporosis than the control group (adjusted hazard ratio, 1.09; P less than .001). In study 2 (a nested case-control study), the osteoporosis group had a significantly higher prevalence of psoriasis than the control group (adjusted odds ratio, 1.21; P less than .001).

Study details: A total of 25,306 patients with psoriasis were matched (1:4) to 101,224 controls (study 1) and 79,212 patients with osteoporosis were matched (1:1) to 79,212 controls (study 2).

Disclosures: The work was supported in part by a research grant from the National Research Foundation of Korea. The authors reported no conflicts of interest.

Source: Lee JW et al. Osteoporos Int. 2020 Nov 5. doi: 10.1007/s00198-020-05724-2.

Key clinical point: Psoriasis was associated with an elevated risk of osteoporosis in individuals aged 40 years or older.

Major finding: In study 1 (a follow-up study), the psoriasis group had a significantly higher risk of osteoporosis than the control group (adjusted hazard ratio, 1.09; P less than .001). In study 2 (a nested case-control study), the osteoporosis group had a significantly higher prevalence of psoriasis than the control group (adjusted odds ratio, 1.21; P less than .001).

Study details: A total of 25,306 patients with psoriasis were matched (1:4) to 101,224 controls (study 1) and 79,212 patients with osteoporosis were matched (1:1) to 79,212 controls (study 2).

Disclosures: The work was supported in part by a research grant from the National Research Foundation of Korea. The authors reported no conflicts of interest.

Source: Lee JW et al. Osteoporos Int. 2020 Nov 5. doi: 10.1007/s00198-020-05724-2.

Key clinical point: Psoriasis was associated with an elevated risk of osteoporosis in individuals aged 40 years or older.

Major finding: In study 1 (a follow-up study), the psoriasis group had a significantly higher risk of osteoporosis than the control group (adjusted hazard ratio, 1.09; P less than .001). In study 2 (a nested case-control study), the osteoporosis group had a significantly higher prevalence of psoriasis than the control group (adjusted odds ratio, 1.21; P less than .001).

Study details: A total of 25,306 patients with psoriasis were matched (1:4) to 101,224 controls (study 1) and 79,212 patients with osteoporosis were matched (1:1) to 79,212 controls (study 2).

Disclosures: The work was supported in part by a research grant from the National Research Foundation of Korea. The authors reported no conflicts of interest.

Source: Lee JW et al. Osteoporos Int. 2020 Nov 5. doi: 10.1007/s00198-020-05724-2.

Key clinical point: Romosozumab followed by denosumab results in significant bone mineral density (BMD) gains and numerically lower vertebral fractures in postmenopausal Japanese women with osteoporosis at high risk of fracture vs. placebo followed by denosumab through 36 months of follow-up.

Major finding: At 12, 24, and 36 months, the incidence of new vertebral fractures was lower with romosozumab/denosumab vs. placebo/denosumab (relative risk reduction at all timepoints: 84%; P = .056). BMD increase at 12, 24, and 36 months were greater with romosozumab/denosumab vs. placebo/denosumab (lumbar spine: 16.3%, 21.5%, and 23.2% vs. 0.4%, 8.1%, and 10.4%; total hip: 4.9%, 7.9%, and 8.9% vs. 0.4%, 2.8%, and 4.1%; femoral neck: 4.8%, 7.6%, and 8.1% vs. 0.3%, 3.3%, and 3.7%, respectively; all P less than .001).

Study details: This post hoc analysis of phase 3 FRAME study included 187 postmenopausal Japanese women with osteoporosis at high risk of fracture (romosozumab/denosumab group, n = 91; placebo/denosumab group, n = 96).

Disclosures: This study was funded by Amgen Inc., Astellas, and UCB Pharma. A Miyauchi received consulting fees from Amgen, Astellas BioPharma K.K., and Teijin Pharma. E Hamaya, K Nishi, and J Shimauchi are employees of Amgen K.K., Japan, and E Hamaya holds stock in Amgen Inc. W Yang is an employee of Amgen Inc., USA. C Libanati is an employee of UCB Pharma, Belgium, and holds stock in UCB Pharma. C Tolman is an employee of Amgen and holds stock in Amgen.

Source: Miyauchi A et al. J Bone Miner Metab. 2020 Oct 15. doi: 10.1007/s00774-020-01147-5.

Key clinical point: Romosozumab followed by denosumab results in significant bone mineral density (BMD) gains and numerically lower vertebral fractures in postmenopausal Japanese women with osteoporosis at high risk of fracture vs. placebo followed by denosumab through 36 months of follow-up.

Major finding: At 12, 24, and 36 months, the incidence of new vertebral fractures was lower with romosozumab/denosumab vs. placebo/denosumab (relative risk reduction at all timepoints: 84%; P = .056). BMD increase at 12, 24, and 36 months were greater with romosozumab/denosumab vs. placebo/denosumab (lumbar spine: 16.3%, 21.5%, and 23.2% vs. 0.4%, 8.1%, and 10.4%; total hip: 4.9%, 7.9%, and 8.9% vs. 0.4%, 2.8%, and 4.1%; femoral neck: 4.8%, 7.6%, and 8.1% vs. 0.3%, 3.3%, and 3.7%, respectively; all P less than .001).

Study details: This post hoc analysis of phase 3 FRAME study included 187 postmenopausal Japanese women with osteoporosis at high risk of fracture (romosozumab/denosumab group, n = 91; placebo/denosumab group, n = 96).

Disclosures: This study was funded by Amgen Inc., Astellas, and UCB Pharma. A Miyauchi received consulting fees from Amgen, Astellas BioPharma K.K., and Teijin Pharma. E Hamaya, K Nishi, and J Shimauchi are employees of Amgen K.K., Japan, and E Hamaya holds stock in Amgen Inc. W Yang is an employee of Amgen Inc., USA. C Libanati is an employee of UCB Pharma, Belgium, and holds stock in UCB Pharma. C Tolman is an employee of Amgen and holds stock in Amgen.

Source: Miyauchi A et al. J Bone Miner Metab. 2020 Oct 15. doi: 10.1007/s00774-020-01147-5.

Key clinical point: Romosozumab followed by denosumab results in significant bone mineral density (BMD) gains and numerically lower vertebral fractures in postmenopausal Japanese women with osteoporosis at high risk of fracture vs. placebo followed by denosumab through 36 months of follow-up.

Major finding: At 12, 24, and 36 months, the incidence of new vertebral fractures was lower with romosozumab/denosumab vs. placebo/denosumab (relative risk reduction at all timepoints: 84%; P = .056). BMD increase at 12, 24, and 36 months were greater with romosozumab/denosumab vs. placebo/denosumab (lumbar spine: 16.3%, 21.5%, and 23.2% vs. 0.4%, 8.1%, and 10.4%; total hip: 4.9%, 7.9%, and 8.9% vs. 0.4%, 2.8%, and 4.1%; femoral neck: 4.8%, 7.6%, and 8.1% vs. 0.3%, 3.3%, and 3.7%, respectively; all P less than .001).

Study details: This post hoc analysis of phase 3 FRAME study included 187 postmenopausal Japanese women with osteoporosis at high risk of fracture (romosozumab/denosumab group, n = 91; placebo/denosumab group, n = 96).

Disclosures: This study was funded by Amgen Inc., Astellas, and UCB Pharma. A Miyauchi received consulting fees from Amgen, Astellas BioPharma K.K., and Teijin Pharma. E Hamaya, K Nishi, and J Shimauchi are employees of Amgen K.K., Japan, and E Hamaya holds stock in Amgen Inc. W Yang is an employee of Amgen Inc., USA. C Libanati is an employee of UCB Pharma, Belgium, and holds stock in UCB Pharma. C Tolman is an employee of Amgen and holds stock in Amgen.

Source: Miyauchi A et al. J Bone Miner Metab. 2020 Oct 15. doi: 10.1007/s00774-020-01147-5.

Key clinical point: Treatment with denosumab in an osteoporosis dosage is not associated with an increased risk of malignancy with drug exposure of up to 48 months.

Major finding: The risk of malignancy was similar between denosumab (60 mg every 6 months, up to 48 months) and other comparators (absolute risk difference, 0%; risk ratio, 1.08; 95% confidence interval, 0.94-1.24).

Study details: Meta-analysis of 25 randomized controlled trials including 21,523 patients with osteoporosis (10,721 treated with denosumab and 10,802 treated with a comparator).

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Rosenberg D et al. Osteoporos Int. 2020 Nov 3. doi: 10.1007/s00198-020-05704-6.

Key clinical point: Treatment with denosumab in an osteoporosis dosage is not associated with an increased risk of malignancy with drug exposure of up to 48 months.

Major finding: The risk of malignancy was similar between denosumab (60 mg every 6 months, up to 48 months) and other comparators (absolute risk difference, 0%; risk ratio, 1.08; 95% confidence interval, 0.94-1.24).

Study details: Meta-analysis of 25 randomized controlled trials including 21,523 patients with osteoporosis (10,721 treated with denosumab and 10,802 treated with a comparator).

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Rosenberg D et al. Osteoporos Int. 2020 Nov 3. doi: 10.1007/s00198-020-05704-6.

Key clinical point: Treatment with denosumab in an osteoporosis dosage is not associated with an increased risk of malignancy with drug exposure of up to 48 months.

Major finding: The risk of malignancy was similar between denosumab (60 mg every 6 months, up to 48 months) and other comparators (absolute risk difference, 0%; risk ratio, 1.08; 95% confidence interval, 0.94-1.24).

Study details: Meta-analysis of 25 randomized controlled trials including 21,523 patients with osteoporosis (10,721 treated with denosumab and 10,802 treated with a comparator).

Disclosures: No study sponsor was identified. The authors declared no conflicts of interest.

Source: Rosenberg D et al. Osteoporos Int. 2020 Nov 3. doi: 10.1007/s00198-020-05704-6.

Key clinical point: Exposure to oral (OCS) and inhaled (ICS) corticosteroid is associated with an increased risk for osteoporosis and fragility fracture (FF) in patients with asthma.

Major finding: Patients receiving more OCS prescriptions (9 or more vs. 0) were at a greater risk for osteoporosis (adjusted odds ratio [aOR], 4.50; 95% confidence interval [CI], 3.21-6.11) and FF (aOR, 2.16; 95% CI, 1.56-3.38). Among patients receiving more ICS prescriptions (11 or more vs. 0), the aORs for osteoporosis and FF were 1.60 (95% CI, 1.22-2.10) and 1.31 (95% CI, 1.02-1.68), respectively.

Study details: Two UK population-based nested case-control studies included 1,564 patients with asthma and osteoporosis (3,313 control participants) and 2,131 with asthma and FF (4,421 control participants).

Disclosures: The study was funded by a research award from the British Medical Association. The authors declared no conflicts of interest.

Source: Chalitsios CV et al. Thorax. 2020 Oct 21. doi: 10.1136/thoraxjnl-2020-215664.

Key clinical point: Exposure to oral (OCS) and inhaled (ICS) corticosteroid is associated with an increased risk for osteoporosis and fragility fracture (FF) in patients with asthma.

Major finding: Patients receiving more OCS prescriptions (9 or more vs. 0) were at a greater risk for osteoporosis (adjusted odds ratio [aOR], 4.50; 95% confidence interval [CI], 3.21-6.11) and FF (aOR, 2.16; 95% CI, 1.56-3.38). Among patients receiving more ICS prescriptions (11 or more vs. 0), the aORs for osteoporosis and FF were 1.60 (95% CI, 1.22-2.10) and 1.31 (95% CI, 1.02-1.68), respectively.

Study details: Two UK population-based nested case-control studies included 1,564 patients with asthma and osteoporosis (3,313 control participants) and 2,131 with asthma and FF (4,421 control participants).

Disclosures: The study was funded by a research award from the British Medical Association. The authors declared no conflicts of interest.

Source: Chalitsios CV et al. Thorax. 2020 Oct 21. doi: 10.1136/thoraxjnl-2020-215664.

Key clinical point: Exposure to oral (OCS) and inhaled (ICS) corticosteroid is associated with an increased risk for osteoporosis and fragility fracture (FF) in patients with asthma.

Major finding: Patients receiving more OCS prescriptions (9 or more vs. 0) were at a greater risk for osteoporosis (adjusted odds ratio [aOR], 4.50; 95% confidence interval [CI], 3.21-6.11) and FF (aOR, 2.16; 95% CI, 1.56-3.38). Among patients receiving more ICS prescriptions (11 or more vs. 0), the aORs for osteoporosis and FF were 1.60 (95% CI, 1.22-2.10) and 1.31 (95% CI, 1.02-1.68), respectively.

Study details: Two UK population-based nested case-control studies included 1,564 patients with asthma and osteoporosis (3,313 control participants) and 2,131 with asthma and FF (4,421 control participants).

Disclosures: The study was funded by a research award from the British Medical Association. The authors declared no conflicts of interest.

Source: Chalitsios CV et al. Thorax. 2020 Oct 21. doi: 10.1136/thoraxjnl-2020-215664.

Key clinical point: Roux-en-Y gastric bypass (RYGB) correlated with greater reduction in areal bone mineral density (aBMD) and greater increase in bone turnover markers vs. sleeve gastrectomy (SG).

Major finding: From baseline to 1 year, aBMD in femoral neck, total hip, and lumbar spine decreased significantly more after RYGB than after SG (mean [95% confidence interval] between group differences: −2.8% [−0.8% to −4.7%], −3.0% [−0.9% to −5.0%], and −4.2% [−2.1% to −6.4%], respectively). The increase in procollagen type 1 N-terminal propeptide and C telopeptide of type I collagen was significantly higher after RYGB vs. SG (P less than .001).

Study details: This randomized, triple-blind, single-center trial included 109 patients with severe obesity and type 2 diabetes randomly assigned (1:1) to RYGB (n = 54) or SG (n = 55).

Disclosures: The study was funded by the Morbid Obesity Center, Vestfold Hospital Trust. F Fatima received an educational grant (PhD) from South-Eastern Norway Regional Health Authority. Other authors had nothing to disclose.

Source: Hofsø D et al. J Clin Endocrinol Metab. 2020 Nov 5. doi: 10.1210/clinem/dgaa808.

Key clinical point: Roux-en-Y gastric bypass (RYGB) correlated with greater reduction in areal bone mineral density (aBMD) and greater increase in bone turnover markers vs. sleeve gastrectomy (SG).

Major finding: From baseline to 1 year, aBMD in femoral neck, total hip, and lumbar spine decreased significantly more after RYGB than after SG (mean [95% confidence interval] between group differences: −2.8% [−0.8% to −4.7%], −3.0% [−0.9% to −5.0%], and −4.2% [−2.1% to −6.4%], respectively). The increase in procollagen type 1 N-terminal propeptide and C telopeptide of type I collagen was significantly higher after RYGB vs. SG (P less than .001).

Study details: This randomized, triple-blind, single-center trial included 109 patients with severe obesity and type 2 diabetes randomly assigned (1:1) to RYGB (n = 54) or SG (n = 55).

Disclosures: The study was funded by the Morbid Obesity Center, Vestfold Hospital Trust. F Fatima received an educational grant (PhD) from South-Eastern Norway Regional Health Authority. Other authors had nothing to disclose.

Source: Hofsø D et al. J Clin Endocrinol Metab. 2020 Nov 5. doi: 10.1210/clinem/dgaa808.

Key clinical point: Roux-en-Y gastric bypass (RYGB) correlated with greater reduction in areal bone mineral density (aBMD) and greater increase in bone turnover markers vs. sleeve gastrectomy (SG).

Major finding: From baseline to 1 year, aBMD in femoral neck, total hip, and lumbar spine decreased significantly more after RYGB than after SG (mean [95% confidence interval] between group differences: −2.8% [−0.8% to −4.7%], −3.0% [−0.9% to −5.0%], and −4.2% [−2.1% to −6.4%], respectively). The increase in procollagen type 1 N-terminal propeptide and C telopeptide of type I collagen was significantly higher after RYGB vs. SG (P less than .001).

Study details: This randomized, triple-blind, single-center trial included 109 patients with severe obesity and type 2 diabetes randomly assigned (1:1) to RYGB (n = 54) or SG (n = 55).

Disclosures: The study was funded by the Morbid Obesity Center, Vestfold Hospital Trust. F Fatima received an educational grant (PhD) from South-Eastern Norway Regional Health Authority. Other authors had nothing to disclose.

Source: Hofsø D et al. J Clin Endocrinol Metab. 2020 Nov 5. doi: 10.1210/clinem/dgaa808.

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.

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.

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.

The issue of race and survival in patients with clear cell renal cell carcinoma (ccRCC) has been debated in the literature.

Some studies have shown worse survival for Black patients, while others have suggested that Black race is instead a stand-in for social determinants, including access to care.

New research suggests that Black race is not correlated with increased mortality from ccRCC. These results were published in Urology.

“Despite well documented racial biases and race-specific outcomes in the health care landscape, our study found race was not associated with 5-year cause-specific survival from ccRCC,” wrote investigator Dhaval Jivanji, a medical student at Florida International University, Miami, and colleagues.

In their retrospective study, the investigators examined 5-year survival in ccRCC patients, comparing results across races. The team used data from the Surveillance Epidemiology, and End Results (SEER) database, which collects cancer data from 13 states using population-based cancer registries. They extracted data on demographics, prevalence, and mortality, in relation to ccRCC.

A total of 8,421 subjects with ccRCC were included in the analysis, which covered the years 2007-2015. The primary outcome was 5-year survival, defined as cause-specific mortality up to the first 60 months from time of cancer diagnosis.

In addition to race, variables included in the statistical model were age (18-50, 51-60, 61-70,71-80, >80), sex (male/female), SEER Summary tumor staging (localized, regionalized, distant), insurance status (uninsured, insured, insured not specific, Medicaid), and marital status (single, married/partner, separated/divorced/widowed).
 

Demographic determinism

In the adjusted analysis, the researchers found no association between race and 5-year cause-specific survival in patients with ccRCC.

The hazard ratios for death were 0.96 for Black patients, 1.01 for American Indian/Alaska Native patients, and 0.99 for Asian/Pacific Islander patients, with White patients as the comparator.

In terms of the other covariates studied, the researchers found that older age (>50 years) and the presence of regional or distant tumors were associated with an increased hazard of death, while female sex and having insurance were associated with a decreased hazard of death.

“Our study found that age, tumor stage, and insurance status are significantly associated with 5-year cause-specific survival. Future studies will benefit from complete assessment of other demographic factors, including income, medical comorbidities, and access to care. These are negative predictors, and [their] potential impact on overall survival should be considered by the clinician in treatment and management plans for RCC patients,” the researchers concluded.

In an editorial commentary published within the main article, Paul Russo, MD, of Weill Cornell Medicine, New York, stated: “Investigations such as this utilizing the SEER registries provide a 30,000-foot demographic view of some disease elements but lack important granularity, such as tumor size and grade, family income, critical medical comorbidities, and patient access to hospitals with surgical and medical oncologic expertise.”

Dr. Russo said it is well known that disparate access to diagnosis, surgical intervention, and expert treatment have an impact on survival.

He went on to ask: “Could African Americans have had superior outcomes if the data was controlled for these important variables? As urologic surgeons, we must join the greater medical community in understanding the root causes leading to structural racial and economic disparities, inequities in access to care, and the profound negative impact these disparities have on health outcomes in general and cancer outcomes specifically.”

The authors did not disclose funding or conflicts of interest.

mlesney@mdedge.com

SOURCE: Jivanji D et al. Urology. 2020. doi: 10.1016/j.urology.2020.10.055.

The issue of race and survival in patients with clear cell renal cell carcinoma (ccRCC) has been debated in the literature.

Some studies have shown worse survival for Black patients, while others have suggested that Black race is instead a stand-in for social determinants, including access to care.

New research suggests that Black race is not correlated with increased mortality from ccRCC. These results were published in Urology.

“Despite well documented racial biases and race-specific outcomes in the health care landscape, our study found race was not associated with 5-year cause-specific survival from ccRCC,” wrote investigator Dhaval Jivanji, a medical student at Florida International University, Miami, and colleagues.

In their retrospective study, the investigators examined 5-year survival in ccRCC patients, comparing results across races. The team used data from the Surveillance Epidemiology, and End Results (SEER) database, which collects cancer data from 13 states using population-based cancer registries. They extracted data on demographics, prevalence, and mortality, in relation to ccRCC.

A total of 8,421 subjects with ccRCC were included in the analysis, which covered the years 2007-2015. The primary outcome was 5-year survival, defined as cause-specific mortality up to the first 60 months from time of cancer diagnosis.

In addition to race, variables included in the statistical model were age (18-50, 51-60, 61-70,71-80, >80), sex (male/female), SEER Summary tumor staging (localized, regionalized, distant), insurance status (uninsured, insured, insured not specific, Medicaid), and marital status (single, married/partner, separated/divorced/widowed).
 

Demographic determinism

In the adjusted analysis, the researchers found no association between race and 5-year cause-specific survival in patients with ccRCC.

The hazard ratios for death were 0.96 for Black patients, 1.01 for American Indian/Alaska Native patients, and 0.99 for Asian/Pacific Islander patients, with White patients as the comparator.

In terms of the other covariates studied, the researchers found that older age (>50 years) and the presence of regional or distant tumors were associated with an increased hazard of death, while female sex and having insurance were associated with a decreased hazard of death.

“Our study found that age, tumor stage, and insurance status are significantly associated with 5-year cause-specific survival. Future studies will benefit from complete assessment of other demographic factors, including income, medical comorbidities, and access to care. These are negative predictors, and [their] potential impact on overall survival should be considered by the clinician in treatment and management plans for RCC patients,” the researchers concluded.

In an editorial commentary published within the main article, Paul Russo, MD, of Weill Cornell Medicine, New York, stated: “Investigations such as this utilizing the SEER registries provide a 30,000-foot demographic view of some disease elements but lack important granularity, such as tumor size and grade, family income, critical medical comorbidities, and patient access to hospitals with surgical and medical oncologic expertise.”

Dr. Russo said it is well known that disparate access to diagnosis, surgical intervention, and expert treatment have an impact on survival.

He went on to ask: “Could African Americans have had superior outcomes if the data was controlled for these important variables? As urologic surgeons, we must join the greater medical community in understanding the root causes leading to structural racial and economic disparities, inequities in access to care, and the profound negative impact these disparities have on health outcomes in general and cancer outcomes specifically.”

The authors did not disclose funding or conflicts of interest.

mlesney@mdedge.com

SOURCE: Jivanji D et al. Urology. 2020. doi: 10.1016/j.urology.2020.10.055.

The issue of race and survival in patients with clear cell renal cell carcinoma (ccRCC) has been debated in the literature.

Some studies have shown worse survival for Black patients, while others have suggested that Black race is instead a stand-in for social determinants, including access to care.

New research suggests that Black race is not correlated with increased mortality from ccRCC. These results were published in Urology.

“Despite well documented racial biases and race-specific outcomes in the health care landscape, our study found race was not associated with 5-year cause-specific survival from ccRCC,” wrote investigator Dhaval Jivanji, a medical student at Florida International University, Miami, and colleagues.

In their retrospective study, the investigators examined 5-year survival in ccRCC patients, comparing results across races. The team used data from the Surveillance Epidemiology, and End Results (SEER) database, which collects cancer data from 13 states using population-based cancer registries. They extracted data on demographics, prevalence, and mortality, in relation to ccRCC.

A total of 8,421 subjects with ccRCC were included in the analysis, which covered the years 2007-2015. The primary outcome was 5-year survival, defined as cause-specific mortality up to the first 60 months from time of cancer diagnosis.

In addition to race, variables included in the statistical model were age (18-50, 51-60, 61-70,71-80, >80), sex (male/female), SEER Summary tumor staging (localized, regionalized, distant), insurance status (uninsured, insured, insured not specific, Medicaid), and marital status (single, married/partner, separated/divorced/widowed).
 

Demographic determinism

In the adjusted analysis, the researchers found no association between race and 5-year cause-specific survival in patients with ccRCC.

The hazard ratios for death were 0.96 for Black patients, 1.01 for American Indian/Alaska Native patients, and 0.99 for Asian/Pacific Islander patients, with White patients as the comparator.

In terms of the other covariates studied, the researchers found that older age (>50 years) and the presence of regional or distant tumors were associated with an increased hazard of death, while female sex and having insurance were associated with a decreased hazard of death.

“Our study found that age, tumor stage, and insurance status are significantly associated with 5-year cause-specific survival. Future studies will benefit from complete assessment of other demographic factors, including income, medical comorbidities, and access to care. These are negative predictors, and [their] potential impact on overall survival should be considered by the clinician in treatment and management plans for RCC patients,” the researchers concluded.

In an editorial commentary published within the main article, Paul Russo, MD, of Weill Cornell Medicine, New York, stated: “Investigations such as this utilizing the SEER registries provide a 30,000-foot demographic view of some disease elements but lack important granularity, such as tumor size and grade, family income, critical medical comorbidities, and patient access to hospitals with surgical and medical oncologic expertise.”

Dr. Russo said it is well known that disparate access to diagnosis, surgical intervention, and expert treatment have an impact on survival.

He went on to ask: “Could African Americans have had superior outcomes if the data was controlled for these important variables? As urologic surgeons, we must join the greater medical community in understanding the root causes leading to structural racial and economic disparities, inequities in access to care, and the profound negative impact these disparities have on health outcomes in general and cancer outcomes specifically.”

The authors did not disclose funding or conflicts of interest.

mlesney@mdedge.com

SOURCE: Jivanji D et al. Urology. 2020. doi: 10.1016/j.urology.2020.10.055.

Breast cancer now tops the list of the most commonly diagnosed cancers worldwide, surpassing lung cancer for the first time, according to the latest global cancer burden estimates from the International Agency for Research on Cancer (IARC).

Breast cancer among women accounted for 11.7% of the estimated 19.3 million new cancer cases in 2020 ― and about 25% of all cancer cases among women. Lung cancer accounted for 11.4% of new cases, reports the IARC, part of the World Health Organization.

However, lung cancer remains the leading overall cause of cancer mortality, accounting for 18.0% of 10 million cancer deaths. Breast cancer ranks fifth as a cause of cancer mortality, accounting for 1 of every 6 cancer deaths in women and 685,000 deaths overall (6.9%) in 2020, but it ranks first in incidence in 159 countries and first in mortality in 110 countries, the data show.

The increase in breast cancer cases is likely attributable to the effects of “marked changes in lifestyle, sociocultural contexts, and built environments” in many countries, says the IACR. These include delayed childbearing, having fewer children, increased rates of overweight and obesity, and decreasing levels of physical activity, the IACR explains in a press release.

These new data underscore the importance of focusing on cancer prevention, IARC Director Elisabete Weiderpass, MD, states in the press release.

“Effective interventions for prevention and early detection are available and must be integrated into cancer planning to control the predicted upsurge of this devastating disease,” she said.

Weiderpass also notes that the “overwhelming need for evidence-based and resource-stratified guidelines that support the phased implementation of breast cancer early detection and treatment into real-world practice.”

To that end, the WHO and the IARC will launch a global breast cancer initiative in 2021 to improve population-level outcomes through a focus on more timely diagnosis and comprehensive treatment, she adds.

The most common cancer diagnoses worldwide after breast cancer and lung cancer are colorectal cancer (10.0%), prostate cancer (7.3%), and stomach cancer (5.6%).

The leading causes of cancer deaths after lung cancer are colorectal cancer (9.4%), liver cancer (8.3%), stomach cancer (7.7%), and breast cancer among women.
 

One in five people will develop cancer

The IACR estimates that 1 in 5 people will develop cancer in their lifetime and that 1 in 8 men and 1 in 11 women will die from it.

Among women, breast cancer is the most common cancer type and the most common cause of cancer death. Colorectal cancer and lung cancer are the second and third most common cancer types and the third and second most common causes of cancer death, respectively.

Among men, lung cancer is the most common cancer type and the most common cause of cancer death. Prostate cancer and colorectal cancer are the second and third most common cancer types, and liver cancer and colorectal cancer are the second and third most common causes of cancer death.

“Worldwide, an estimated 28.4 million new cancer cases are projected to occur in 2040, a 47% increase from the estimated 19.3 million cases in 2020,” the IARC notes.

The agency derives its estimates from the GLOBOCAN 2020 database, which tracks 185 countries and 36 types of cancer and is accessible through the IARC Global Cancer Observatory.

A version of this article first appeared on Medscape.com.

Breast cancer now tops the list of the most commonly diagnosed cancers worldwide, surpassing lung cancer for the first time, according to the latest global cancer burden estimates from the International Agency for Research on Cancer (IARC).

Breast cancer among women accounted for 11.7% of the estimated 19.3 million new cancer cases in 2020 ― and about 25% of all cancer cases among women. Lung cancer accounted for 11.4% of new cases, reports the IARC, part of the World Health Organization.

However, lung cancer remains the leading overall cause of cancer mortality, accounting for 18.0% of 10 million cancer deaths. Breast cancer ranks fifth as a cause of cancer mortality, accounting for 1 of every 6 cancer deaths in women and 685,000 deaths overall (6.9%) in 2020, but it ranks first in incidence in 159 countries and first in mortality in 110 countries, the data show.

The increase in breast cancer cases is likely attributable to the effects of “marked changes in lifestyle, sociocultural contexts, and built environments” in many countries, says the IACR. These include delayed childbearing, having fewer children, increased rates of overweight and obesity, and decreasing levels of physical activity, the IACR explains in a press release.

These new data underscore the importance of focusing on cancer prevention, IARC Director Elisabete Weiderpass, MD, states in the press release.

“Effective interventions for prevention and early detection are available and must be integrated into cancer planning to control the predicted upsurge of this devastating disease,” she said.

Weiderpass also notes that the “overwhelming need for evidence-based and resource-stratified guidelines that support the phased implementation of breast cancer early detection and treatment into real-world practice.”

To that end, the WHO and the IARC will launch a global breast cancer initiative in 2021 to improve population-level outcomes through a focus on more timely diagnosis and comprehensive treatment, she adds.

The most common cancer diagnoses worldwide after breast cancer and lung cancer are colorectal cancer (10.0%), prostate cancer (7.3%), and stomach cancer (5.6%).

The leading causes of cancer deaths after lung cancer are colorectal cancer (9.4%), liver cancer (8.3%), stomach cancer (7.7%), and breast cancer among women.
 

One in five people will develop cancer

The IACR estimates that 1 in 5 people will develop cancer in their lifetime and that 1 in 8 men and 1 in 11 women will die from it.

Among women, breast cancer is the most common cancer type and the most common cause of cancer death. Colorectal cancer and lung cancer are the second and third most common cancer types and the third and second most common causes of cancer death, respectively.

Among men, lung cancer is the most common cancer type and the most common cause of cancer death. Prostate cancer and colorectal cancer are the second and third most common cancer types, and liver cancer and colorectal cancer are the second and third most common causes of cancer death.

“Worldwide, an estimated 28.4 million new cancer cases are projected to occur in 2040, a 47% increase from the estimated 19.3 million cases in 2020,” the IARC notes.

The agency derives its estimates from the GLOBOCAN 2020 database, which tracks 185 countries and 36 types of cancer and is accessible through the IARC Global Cancer Observatory.

A version of this article first appeared on Medscape.com.

Breast cancer now tops the list of the most commonly diagnosed cancers worldwide, surpassing lung cancer for the first time, according to the latest global cancer burden estimates from the International Agency for Research on Cancer (IARC).

Breast cancer among women accounted for 11.7% of the estimated 19.3 million new cancer cases in 2020 ― and about 25% of all cancer cases among women. Lung cancer accounted for 11.4% of new cases, reports the IARC, part of the World Health Organization.

However, lung cancer remains the leading overall cause of cancer mortality, accounting for 18.0% of 10 million cancer deaths. Breast cancer ranks fifth as a cause of cancer mortality, accounting for 1 of every 6 cancer deaths in women and 685,000 deaths overall (6.9%) in 2020, but it ranks first in incidence in 159 countries and first in mortality in 110 countries, the data show.

The increase in breast cancer cases is likely attributable to the effects of “marked changes in lifestyle, sociocultural contexts, and built environments” in many countries, says the IACR. These include delayed childbearing, having fewer children, increased rates of overweight and obesity, and decreasing levels of physical activity, the IACR explains in a press release.

These new data underscore the importance of focusing on cancer prevention, IARC Director Elisabete Weiderpass, MD, states in the press release.

“Effective interventions for prevention and early detection are available and must be integrated into cancer planning to control the predicted upsurge of this devastating disease,” she said.

Weiderpass also notes that the “overwhelming need for evidence-based and resource-stratified guidelines that support the phased implementation of breast cancer early detection and treatment into real-world practice.”

To that end, the WHO and the IARC will launch a global breast cancer initiative in 2021 to improve population-level outcomes through a focus on more timely diagnosis and comprehensive treatment, she adds.

The most common cancer diagnoses worldwide after breast cancer and lung cancer are colorectal cancer (10.0%), prostate cancer (7.3%), and stomach cancer (5.6%).

The leading causes of cancer deaths after lung cancer are colorectal cancer (9.4%), liver cancer (8.3%), stomach cancer (7.7%), and breast cancer among women.
 

One in five people will develop cancer

The IACR estimates that 1 in 5 people will develop cancer in their lifetime and that 1 in 8 men and 1 in 11 women will die from it.

Among women, breast cancer is the most common cancer type and the most common cause of cancer death. Colorectal cancer and lung cancer are the second and third most common cancer types and the third and second most common causes of cancer death, respectively.

Among men, lung cancer is the most common cancer type and the most common cause of cancer death. Prostate cancer and colorectal cancer are the second and third most common cancer types, and liver cancer and colorectal cancer are the second and third most common causes of cancer death.

“Worldwide, an estimated 28.4 million new cancer cases are projected to occur in 2040, a 47% increase from the estimated 19.3 million cases in 2020,” the IARC notes.

The agency derives its estimates from the GLOBOCAN 2020 database, which tracks 185 countries and 36 types of cancer and is accessible through the IARC Global Cancer Observatory.

A version of this article first appeared on Medscape.com.