Evidence map›Paper›PMID 42423749›Full record

ArticleCalcified tissue international2026

Cardiovascular Safety of Romosozumab Versus Other Anti-Osteoporosis Medications in Patients with Osteoporosis: A Nationwide Health Insurance Claims Database Study in Japan.

Yuki Fujita, Katsuyasu Kouda, Kenji Fujimori, Nobukazu Okimoto, Shinichi Nakatoh, Junko Tamaki, Shigeyuki Ishii, Sumito Ogawa, Masayuki Iki

Abstract read
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In one paragraph

Article in Calcified tissue international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yuki FujitaDepartment of Hygiene and Public Health, Faculty of Medicine, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan. fujita.yuu@kmu.ac.jp.ORCID http://orcid.org/0000-0002-7490-258X
Katsuyasu KoudaDepartment of Hygiene and Public Health, Faculty of Medicine, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan.
Kenji FujimoriDepartment of Health Administration and Policy, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Nobukazu OkimotoOkimoto Clinic, 185-4 Kubi, Yutaka-machi, Kure, Hiroshima, 734-0304, Japan.
Shinichi NakatohDepartment of Orthopedic Surgery, Asahi General Hospital, 477 Tomari, Asahimachi, Shimo-Niikawa-gun, Toyama, 939-0798, Japan.
Junko TamakiDepartment of Hygiene and Public Health, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan.
Shigeyuki IshiiDepartment of Regulatory Science, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachiouji, Tokyo, 193-0392, Japan.
Sumito OgawaDepartment of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Masayuki IkiDepartment of Hygiene and Public Health, Faculty of Medicine, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan.

Funding

Japan Society for the Promotion of Science 24K13536
6 · The paper itself

Abstract

Romosozumab (Rmab) is a potent anti-osteoporosis agent with dual effects on bone resorption and formation. Although superior to alendronate in fracture reduction, cardiovascular safety concerns have been raised. This study compared cardiovascular disease (CVD) incidence between Rmab and other anti-osteoporosis medications (AOMs) using Japan's National Database of Health Insurance Claims. Patients aged  ≥ 50 years initiating Rmab, parathyroid hormone analogues (PTH), denosumab (Dmab), or bisphosphonates (BP) between March 2019 and March 2023 were identified. Outcomes were acute myocardial infarction, ischemic heart disease, and cerebrovascular disease occurring within 570 days of initiation or within 180 days after discontinuation. Patients with prior myocardial infarction or cerebrovascular disease were excluded. Hazard ratios (HRs) were derived from Cox regression with inverse probability weighting using propensity scores. The study included 25,584 men and 236,467 women receiving Rmab; 50,688 and 289,132 on PTH; 50,319 and 460,182 on Dmab; and 232,484 and 1,144,757 on BP. Cumulative incidence of outcomes was highest with PTH, followed by Dmab, BP, and lowest with Rmab. Compared with PTH, adjusted HRs for Rmab in men were 0.49 for acute myocardial infarction, 0.59 for ischemic heart disease, and 0.70 for cerebrovascular disease. Compared with Dmab, HRs were 0.62, 0.62, and 0.59, respectively. Versus BP, HRs were 0.68, 0.74, and 0.72. All HRs were similarly below 1.0 in women. After adjustment for baseline characteristics, no excess incidence of cardiovascular events was observed among patients receiving Rmab compared with those receiving other AOMs.

Indexed as

Bone Density Conservation AgentsCardiovascular DiseasesOsteoporosisAgedAged, 80 and overDatabases, FactualFemaleHumansIncidenceJapanMaleMiddle AgedBone Density Conservation AgentsAnti-osteoporosis medicationsCardiovascular safetyNationwide health insurance claims database studyOsteoporosisRomosozumab

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.