{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:26:47Z","timestamp":1793060807394,"version":"4.5.0"},"reference-count":31,"publisher":"Korean Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-enm.org"],"crossmark-restriction":true},"short-container-title":["Endocrinol Metab"],"published-print":{"date-parts":[[2026,6,30]]},"abstract":"<jats:p>Background: Romosozumab, a potent anabolic agent for osteoporosis, has been associated with an increased risk of adjudicated cardiovascular events compared with alendronate in postmenopausal women, although such an association was not observed in a placebo-controlled trial. Evidence from real-world clinical practice remains limited.Methods: In this multicenter observational study, we analyzed patients aged \u226550 years who were newly prescribed romosozumab 120 mg monthly or denosumab 60 mg every 6 months for osteoporosis at three tertiary hospitals in South Korea between January 1, 2020, and the end of each site\u2019s data collection period. The primary outcomes were major adverse cardiovascular events (MACE; acute myocardial infarction, ischemic stroke, or sudden cardiac death) and all cardiovascular adverse events (CVAEs; MACE, heart failure, peripheral artery disease, and non-coronary revascularization), assessed at 1- and 3-year follow-up. Large-scale 1:1 propensity score matching and Cox proportional hazards models were applied within a common data model framework with individual-level meta-analysis.Results: A total of 4,896 patients were included in the MACE analysis (4,758 in the CVAE analysis). At 1 year, the incidence rate of MACE did not differ significantly between the romosozumab and denosumab groups (9.20 per 1,000 person-years vs. 6.43 per 1,000 person-years; adjusted hazard ratio [aHR], 1.42; 95% confidence interval [CI], 0.64 to 3.19). The risk of CVAE was also similar between groups (16.23 per 1,000 person-years vs. 15.45 per 1,000 person-years; aHR, 1.05; 95% CI, 0.62 to 1.78). At 3 years, no significant differences were observed for MACE (aHR, 1.51; 95% CI, 0.79 to 2.88) or CVAE (aHR, 1.04; 95% CI, 0.69 to 1.58).Conclusion: In real-world clinical practice, romosozumab use was not associated with a statistically significant increase in cardiovascular risk compared with denosumab.<\/jats:p>","DOI":"10.3803\/enm.2026.2883","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T07:35:13Z","timestamp":1778830513000},"page":"442-451","update-policy":"https:\/\/doi.org\/10.3803\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk of Cardiovascular Events in Patients with Osteoporosis on Romosozumab Treatment Compared with Denosumab: A Multicenter Observational Cohort Study"],"prefix":"10.3803","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2558-2118","authenticated-orcid":true,"given":"Seong Hee","family":"Ahn","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6855-3723","authenticated-orcid":true,"given":"Dachung","family":"Boo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea"},{"name":"Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoung Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimi","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyemin","family":"Yoon","sequence":"additional","affiliation":[{"name":"Big Data Research Center, Asan Institute of Life Science, Asan Medical Center, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chai Young","family":"Jung","sequence":"additional","affiliation":[{"name":"Biomedical Research Institute, Inha University Hospital, Incheon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seng Chan","family":"You","sequence":"additional","affiliation":[{"name":"Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea"},{"name":"Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6773-8320","authenticated-orcid":true,"given":"Ji Seon","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Information Medicine, Asan Medical Center, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8246-1956","authenticated-orcid":true,"given":"Namki","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, 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