{"id":"c3eefff6acb2","type":"article","url":"https://hartvaat.nl/2026/08/12/romosozumab-vermindert-wervelfracturen-en-mace-bij-osteoporose-met-chronische-ni/","title":"Romosozumab vermindert wervelfracturen en MACE bij osteoporose met chronische nierziekte — TriNetX-cohort","title_en":"Comparative Effectiveness and Cardiovascular Safety of Romosozumab versus Teriparatide in Osteoporosis Patients with CKD: Target Trial Emulation Study.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["apotheker","cardioloog","internist"],"tags":[],"journal":"Clinical journal of the American Society of Nephrology : CJASN","doi":"10.2215/CJN.0000001168","source_url":"https://doi.org/10.2215/CJN.0000001168","authors":["Cheng-Hsien Hung","Fu-Yu Yang","Hung-En Huang","James Cheng-Chung Wei"],"significance":6,"published":"2026-08-20","source_date":"2026-08-12","image":"https://hartvaat.nl/global/img/0155cc89a708.webp","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/nierziekte/nsaids-en-nierziekte/"],"congress":"","summary_en":"A retrospective target trial emulation using TriNetX real-world data compared romosozumab and teriparatide in patients aged ≥40 with osteoporosis and CKD (eGFR <60). Romosozumab was associated with a significantly lower risk of vertebral fractures (HR 0.64) and improved cardiovascular safety, showing reduced MACE (HR 0.82) and myocardial infarction (HR 0.77) compared to teriparatide. These findings suggest a potential dual benefit of romosozumab in high-risk CKD patients, though prospective trials are needed to confirm efficacy and safety in advanced kidney disease.","created":"2026-08-13T01:37:05Z","updated":"2026-08-13T01:37:07Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een retrospectieve cohortstudie met TriNetX-data vergeleek romosozumab en teriparatide bij patiënten met osteoporose en een eGFR <60 ml/min/1,73 m². Romosozumab ging gepaard met een lager risico op wervelfracturen (HR 0,64) en een gunstiger cardiovasculair veiligheidsprofiel, met minder MACE (HR 0,82) en myocardinfarcten (HR 0,77) dan teriparatide. Deze bevindingen suggereren een mogelijk dubbel voordeel van romosozumab in deze kwetsbare populatie, maar benadrukken dat prospectieve studies nodig zijn om de effecten bij gevorderde CKD te bevestigen.","abstract_original":"BACKGROUND: Osteoporosis commonly coexists with chronic kidney disease (CKD), increasing skeletal fragility and cardiovascular risk. While romosozumab shows superior fracture prevention in general osteoporosis, evidence in chronic kidney disease stages 3-5 patients remains limited. METHODS: Using a target trial emulation design, we conducted a retrospective cohort study leveraging the TriNetX U.S. research network. Patients aged ≥40 years with osteoporosis and an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 were included. After 1:1 propensity score matching (PSM), outcomes were assessed using Cox proportional hazards models. The primary effectiveness outcomes were non-vertebral and vertebral fractures within 12 months. The secondary outcome was hip fractures. Safety outcomes included MACE, myocardial infarction (MI), stroke, and all-cause mortality. RESULTS: After PSM, 2,045 patients were included in each group. Romosozumab was associated with a significantly lower risk of vertebral fractures compared with teriparatide (HR, 0.64; 95% CI, 0.42-0.98), whereas no significant differences were observed for non-vertebral or hip fractures. In terms of cardiovascular safety, romosozumab was linked to a reduced risk of MACE (HR, 0.82; 95% CI, 0.70-0.97) and MI (HR, 0.77; 95% CI, 0.63-0.95). These findings were generally consistent across most subgroups and sensitivity analyses. CONCLUSION: In patients with osteoporosis and CKD, romosozumab was more effective than teriparatide in reducing vertebral fracture risk and was associated with a lower incidence of major cardiovascular events. These findings support the potential dual benefits of romosozumab in this high-risk population and highlight the need for further prospective studies, particularly in those with advanced CKD."}