Anabolic bone-forming agents may not increase risk of primary bone cancer
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Key takeaways:
- In the risk factor excluded cohort, 0.02% of patients in the anabolic group developed primary bone malignancy.
- Primary bone malignancy was developed among 5.96% of high-risk patients in the anabolic group.
LAS VEGAS — Results presented at the American Academy of Orthopaedic Surgeons Annual Meeting showed patients who were prescribed anabolic bone-forming medications were not at increased risk for developing primary bone neoplasm.
“Further prospective studies with long-term monitoring data may demonstrate the benefit of these medications with ongoing monitoring for malignancy,” Daniel J. Alsoof, BS, MBBS, a research fellow in the department of orthopedics at Brown University, said in his presentation here.
Using the PearlDiver Mariner database between 2010 and 2020, Alsoof and colleagues compared 44,728 patients with osteoporosis who were prescribed teriparatide or abaloparatide with a matched control group to evaluate risk for primary bone cancer development.
“Patients were subsequently grouped as low risk or high risk according to the presence of risk factors for primary bone malignancies, including age greater than 50 years old, history of cancer and risk factors, such as Paget’s disease of the bone and history of alkylating agents,” Alsoof said. “A matched control group was created for each of these cohorts where there was no history of anabolic treatment.”
Alsoof noted 1,241 patients in the anabolic-exposed cohort with at least one risk factor for osteosarcoma were matched for age, gender and Charlson Comorbidity Index with 6,199 control patients. When looking at patients without risk factors for primary bone malignancies, Alsoof said 0.02% of patients in the anabolic treatment group developed a primary bone malignancy vs. 0.05% of patients in the control group. He added 5.96% of high-risk patients in the anabolic treatment group and 8.13% of patients in the control group developed a primary bone malignancy.
“In the risk factor-excluded cohort, there was an incidence rate ratio of 0.56 for the development of primary bone malignancies,” Alsoof said. “In the risk factor-included cohort, there was an incidence rate ratio of 0.95. In both of these cohorts, the incidence rate ratio was insignificant.”
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Alsoof DJ, et al. Paper 399. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 7-11, 2023; Las Vegas.
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