Potential Cardiovascular Risk of Novel Osteoporosis Drug

Dawn O'Shea

July 02, 2020

New research from the University of Oxford's Big Data Institute and the Nuffield Department of Population Health suggests the anti-osteoporotic medicine, romosozumab, may lead to excess cardiovascular complications.

Previous clinical trials of the sclerostin blocker romosozumab have suggested that the medicine may increase the risk of developing serious cardiovascular complications. However, this finding was not consistently seen across all trials, which limits conclusions about the safety of romosozumab.

This study analysed genetic data from more than a million people and found that variants of the SOST gene, which codes for the negative bone regulator sclerostin, had, on average, a 41 per cent lower risk of sustaining a fracture but an 18 per cent increased risk of major adverse cardiovascular events with romosozumab, which inhibits sclerostin. The same variants were also associated with increased risk of type 2 diabetes mellitus, higher systolic blood pressure and central adiposity.

First author, Dr Jonas Bovijn, from the Big Data Institute at the University of Oxford, said the findings suggest that the cardiovascular effects seen in some trials are real.

“This emphasizes the importance of conducting further rigorous clinical studies to evaluate the cardiovascular safety of this class of medicines,” he said.

The findings suggest that inhibition of sclerostin may elevate cardiovascular risk. The results warrant rigorous evaluation of the cardiovascular safety of romosozumab and other sclerostin inhibitors, the authors say.

Bovijn J, Krebs K, Chen C-Y, Boxall R, Censin JC, Ferreira T, Pulit SL, Glastonbury CA, Laber S, Millwood IY, Lin K, Li L, Chen Z, Milani L, Smith GD, Walters RG, Mägi R, Neale BM, Lindgren CM, Holmes MV. Evaluating the cardiovascular safety of sclerostin inhibition using evidence from meta-analysis of clinical trials and human genetics. Sci Transl Med. 2020 June 24. doi: 10.1126/scitranslmed.aay6570 Full text.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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