{"doi":"10.1136/bmj-2022-073435","title":"Denosumab and incidence of type 2 diabetes among adults with osteoporosis: population based cohort study","abstract":"OBJECTIVE: To estimate the effect of denosumab compared with oral bisphosphonates on reducing the risk of type 2 diabetes in adults with osteoporosis. DESIGN: Population based study involving emulation of a randomized target trial using electronic health records. SETTING: IQVIA Medical Research Data primary care database in the United Kingdom, 1995-2021. PARTICIPANTS: Adults aged 45 years or older who used denosumab or an oral bisphosphonate for osteoporosis. MAIN OUTCOME MEASURES: The primary outcome was incident type 2 diabetes, as defined by diagnostic codes. Cox proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals, comparing denosumab with oral bisphosphonates using an as treated approach. RESULTS: 4301 new users of denosumab were matched on propensity score to 21 038 users of an oral bisphosphonate and followed for a mean of 2.2 years. The incidence rate of type 2 diabetes in denosumab users was 5.7 (95% confidence interval 4.3 to 7.3) per 1000 person years and in oral bisphosphonate users was 8.3 (7.4 to 9.2) per 1000 person years. Initiation of denosumab was associated with a reduced risk of type 2 diabetes (hazard ratio 0.68, 95% confidence interval 0.52 to 0.89). Participants with prediabetes appeared to benefit more from denosumab compared with an oral bisphosphonate (hazard ratio 0.54, 0.35 to 0.82), as did those with a body mass index ≥30 (0.65, 0.40 to 1.06). CONCLUSIONS: In this population based study, denosumab use was associated with a lower risk of incident type 2 diabetes compared with oral bisphosphonate use in adults with osteoporosis. This study provides evidence at a population level that denosumab may have added benefits for glucose metabolism compared with oral bisphosphonates.","journal":"BMJ","year":2023,"id":318600,"datarank":1.4968968015051938,"base_score":4.1588830833596715,"endowment":4.1588830833596715,"self_citation_contribution":0.6238324625039509,"citation_network_contribution":0.8730643390012428,"self_endowment_contribution":0.6238324625039509,"citer_contribution":0.8730643390012428,"corpus_percentile":86.12980583275315,"corpus_rank":1794,"citation_count":63,"citer_count":55,"citers_with_citation_signal":36,"citers_with_endowment":36,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5394,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":4.1667,"fair_percentile":4.891470498318557,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":463466,"name":"Sizheng Steven Zhao","orcid":"0000-0002-3558-7353","position":1,"is_corresponding":false},{"id":1025969,"name":"Licheng Zhang","orcid":"0000-0002-6782-1749","position":2,"is_corresponding":false},{"id":477511,"name":"Jie Wei","orcid":"0000-0003-3510-8241","position":3,"is_corresponding":false},{"id":1025970,"name":"Xiaoxiao Li","orcid":"0000-0003-1612-0691","position":4,"is_corresponding":false},{"id":942168,"name":"Hui Li","orcid":"0000-0002-7184-592X","position":5,"is_corresponding":false},{"id":388696,"name":"Yi Liu","orcid":"0000-0003-0169-1125","position":6,"is_corresponding":false},{"id":1025971,"name":"Pengbin Yin","orcid":"0000-0002-5391-4477","position":7,"is_corresponding":false},{"id":1025972,"name":"Vibeke Norvang","orcid":"0000-0002-1222-3653","position":8,"is_corresponding":false},{"id":388934,"name":"Kazuki Yoshida","orcid":"0000-0002-2030-3549","position":9,"is_corresponding":false},{"id":335237,"name":"Sara K. Tedeschi","orcid":"0000-0001-9475-1363","position":10,"is_corresponding":false},{"id":477512,"name":"Chao Zeng","orcid":"0000-0003-4889-5731","position":11,"is_corresponding":false},{"id":477514,"name":"Guanghua Lei","orcid":"0000-0003-2987-138X","position":12,"is_corresponding":false},{"id":1025973,"name":"Peifu Tang","orcid":"0000-0003-4279-1704","position":13,"is_corresponding":false},{"id":391215,"name":"Daniel H. Solomon","orcid":"0000-0001-8202-5428","position":14,"is_corresponding":false},{"id":463465,"name":"Houchen Lyu","orcid":"0000-0002-0128-0062","position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":null,"created_at":"2026-07-19T01:07:01.300821Z","pmid":"37072150","pmcid":"PMC10111187","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":0.0,"fair_a":0.0,"fair_i":0.0,"fair_r":8.3333,"fair_zscore":-1.1986,"fair_rationale":{"fair_score":4.17,"has_llm":true,"taxonomy_version":"fair_taxonomy_v5","dimensions":{"F":{"name":"Findable","score":0.0,"criteria":[{"key":"f_dataset_pid","label":"Persistent identifier for the data","kind":"llm","weight":2.0,"fraction":0.0,"verdict":"no","evidence":"f_dataset_pid","grounded":false,"rationale":"No persistent identifier is provided for the study's own dataset.","anchors":["RDA-F1-01D — FAIR Data Maturity Model: 'Data is identified by a persistent identifier' (priorit","RDA-F1-02D — FAIR Data Maturity Model: 'Data is identified by a globally unique identifier'","FsF-F1-02D — F-UJI/FAIRsFAIR: 'Data is assigned a persistent identifier'"],"scored":true,"signal":null},{"key":"f_repository_named","label":"Named repository","kind":"llm","weight":2.0,"fraction":0.0,"verdict":"no","evidence":"f_repository_named","grounded":false,"rationale":"No repository is named as the holder of the study's data.","anchors":["RDA-F4-01M — FAIR Data Maturity Model: metadata is offered so it can be harvested and indexed (","NIH DMS Policy Element 4 (NOT-OD-21-014) — name the repository where data will be archived","NSTC Desirable Characteristics of Data Repositories (2022) — 'Long-Term Sustainability', 'Reten"],"scored":true,"signal":null},{"key":"f_data_availability_statement","label":"Data-availability statement","kind":"llm","weight":2.0,"fraction":0.0,"verdict":"no","evidence":"f_data_availability_statement","grounded":false,"rationale":"The data availability statement says 'No additional data available' and points to a third-party website for the original database, not the study's own data.","anchors":["Colavizza, Hrynaszkiewicz, Staden, Whitaker & McGillivray (2020), 'The citation advantage of li","Springer Nature research data policy — Data Availability Statements: standard statement templat","RDA-F3-01M — metadata clearly and explicitly includes the identifier of the data it describes"],"scored":false,"signal":null},{"key":"f_discovery_metadata","label":"Description of the dataset as an object","kind":"llm","weight":2.0,"fraction":0.0,"verdict":"no","evidence":"f_discovery_metadata","grounded":false,"rationale":"No itemized inventory of the dataset is provided.","anchors":["RDA-F2-01M — 'Rich metadata is provided to allow discovery' (priority Essential)","FsF-F2-01M — F-UJI: 'Metadata includes descriptive core elements to support data findability'","FsF-R1-01MD — F-UJI: 'Metadata specifies the content of the data'"],"scored":false,"signal":null},{"key":"f_dataset_cited","label":"Dataset formally cited","kind":"llm","weight":1.0,"fraction":0.0,"verdict":"no","evidence":"f_dataset_cited","grounded":false,"rationale":"No identifier for the dataset appears anywhere in the paper.","anchors":["FORCE11 Joint Declaration of Data Citation Principles (2014) — data should be cited as a first-","RDA-F3-01M — metadata clearly and explicitly includes the identifier of the data it describes","FsF-F3-01M — F-UJI: 'Metadata includes the identifier of the data it describes'"],"scored":true,"signal":null}]},"A":{"name":"Accessible","score":0.0,"criteria":[{"key":"a_data_openly_accessible","label":"Access route free of preconditions","kind":"llm","weight":2.0,"fraction":0.0,"verdict":"no","evidence":"a_data_openly_accessible","grounded":false,"rationale":"The paper does not provide a dataset identifier, repository, or data availability statement pointing to the study's own data; 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For clinical / human-subjects data, deposit in dbGaP or the European Genome-phenome Archive (EGA).","anchors":["yes","partial","no"],"verdict":"no","current":0.0,"evidence":"f_dataset_pid","why":"No persistent identifier is provided for the study's own dataset.","gain":16.67,"priority":"essential","scored":true},{"key":"f_repository_named","dimension":"F","label":"Named repository","action":"Deposit the data in a repository registered in re3data/FAIRsharing (a domain repository such as GEO, SRA, dbGaP, PRIDE, or a generalist such as Zenodo, Dryad, Dataverse) and name it explicitly in the paper. A lab website is not an archive: it has no retention commitment and no accession. 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Cite the clinical / human-subjects repository accession (e.g. from dbGaP or the European Genome-phenome Archive (EGA)) in the reference list."],"model":"deepseek/deepseek-v4-flash","agent_version":"fair_agent_v8","fulltext_source":"epmc_xml"},"fair_model":"deepseek/deepseek-v4-flash","fair_agent_version":"fair_agent_v8","fair_fulltext_source":"epmc_xml","fair_has_llm":true,"fair_computed_at":"2026-07-20T11:14:24.097030Z","clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}