ArticleBMJ oncology2024
Increase in major osteoporotic fractures after therapy with immune checkpoint inhibitors.
Article in BMJ oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Bone health in patients with cancer: a SEOM-SEIOMM consensus review of risk factors, assessment strategies, and management approaches.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Immune Checkpoint Inhibitors and Bone Health: Mechanisms, Clinical Implications, and Emerging Perspectives on Bone Fragility.Current osteoporosis reports · 2026Review
- Bone Adverse Events in Cancer Patients Undergoing Immune Checkpoint Inhibitor Therapy: A Comprehensive Review of the Literature from the Clinical Action Group of the European Calcified Tissue Society.Calcified tissue international · 2026Review
- Changes in scanographic bone mineral density in melanoma patients treated with immunotherapy: a new irAE from real-life data.Scientific reports · 2025Article
- Assessing the effects of immune checkpoint inhibitors on bone utilizing machine learning-assisted opportunistic quantitative computed tomography.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Article
- The regulatory effects of PD-1/PD-L1 inhibitors on bone metabolism: opportunities and challenges in osteoporosis management.Frontiers in immunology · 2025Review
- Incidence of fractures in patients with solid cancers treated with immune checkpoint inhibitors: a systematic review and meta-analysis of randomised controlled trials.BMJ oncology · 2025Article
- Osteoporotic fractures: an unrecognized adverse event of immune checkpoint inhibitors?Journal for immunotherapy of cancer · 2024Review
- Determining fracture risk in patients exposed to immune checkpoint inhibitors: the time is now.BMJ oncology · 2024Article
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Authors and funding
7 authors.
Funding
Abstract
Background: Immune checkpoint inhibitors (ICIs) can cause severe and sometimes long-standing immune-related adverse events (irAEs). Enhanced immune activation from ICI can theoretically result in osteoclast activation, bone loss and fracture. The objective of this study was to evaluate the incidence rates of major osteoporotic fractures (MOFs) in patients with melanoma treated with ICI. Methods: We conducted a before-after cohort study using a commercial healthcare claims dataset of adult patients with melanoma from the USA who received ICI therapy between 2011 and 2022. Incidence rates of MOF before and after ICI initiation were ascertained using International Classification of Diseases 9/10 diagnostic codes. Results: The study cohort included 3137 patients, mean age was 68 years, of which 2010 (64%) were men. 40 (1.3%) patients had an MOF in the year before ICI initiation and 57 (1.8%) and 34 (1.8%) had an MOF in the first and second years after ICI initiation, respectively. The HR for MOF over the first year after versus the year before the first ICI dose was 1.82 (95% CI 1.24 to 2.66), and it was 1.85 (95% CI 1.12 to 2.90) over the second year. Prior fracture, older age, female sex and combination ICI therapy were associated with greater risk of MOF after ICI initiation. Conclusion: Patients who receive ICI are at increased risk of MOF after receiving therapy. Given the plausible biological pathway, osteoporosis and osteoporotic fractures may represent a novel irAE of ICI therapy.
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