Treatment effects of denosumab on refracture and mortality in elderly patients following primary osteoporotic hip fracture surgery: real-world data from a retrospective observational study

The effect of denosumab on the risk of refracture and mortality in elderly Chinese patients following primary osteoporotic hip fracture surgery remains to be scarcely investigated. The objective of the study was to investigate the risks of refracture and mortality in elderly patients receiving denosumab .
A retrospective observational study was conducted on elderly patients suffering from primary osteoporotic hip fractures between January 2020 and December 2021 in Zhongshan Hospital, Fudan University. The patients were divided into two groups: denosumab group and control group. PSM and IPTW was performed to adjust between-group differences.
In this study, 379 patients were observed over a period of three years. Following PSM, denosumab treatment had lower risk of refracture than patients without treatment (13.4% vs. 38.3%, subhazard ratio [SHR] = 0.37, 95%CI = 0.22–0.61, p < 0.0001). A lower mortality rate was observed in patients in the denosumab group compared to the control group within three years postoperatively (HR = 0.45, p = 0.001). In patients aged 65–84 years and those aged 85+ years, denosumab was significantly associated with lower risks of refracture and mortality when compared with the control group (p < 0.05). Denosumab treatment had significantly lower risks of refracture and mortality than patients without treatment in the IPTW analysis (SHR = 0.32, p < 0.0001; HR = 0.41, p = 0.001, respectively).
Patients who received treatment with denosumab following primary osteoporotic hip fracture surgery had lower risks of refracture and mortality than patients without treatment, thus underscoring the significance of expeditiously commencing antiosteoporosis treatment in elderly patients after surgery.
Not applicable.