• Japanese study reveals denosumab reduces fracture risk by 45% compared to oral bisphosphonates in dialysis patients over three years, particularly effective for nonvertebral fractures.
• Research identifies potential cardiovascular concerns, with denosumab users showing 3.5 times higher risk of acute myocardial infarction compared to bisphosphonate users.
• Findings highlight important clinical trade-offs, as denosumab's independence from kidney clearance makes it valuable for dialysis patients, despite FDA's recent boxed warning for severe hypocalcemia risk.