Longer denosumab duration tied to higher jaw osteonecrosis but lower skeletal event risk in bone-metastatic prostate cancer
Retrospective · JAMA Netw Open · 2026-10-23. Number 2 in the UrologyWatch Top 5 for October 23, 2026.
In a Korean claims-based target trial emulation of 3,307 men with bone-metastatic castration-resistant prostate cancer, 3-year cumulative incidence was 9.8% for osteonecrosis of the jaw and 4.9% for skeletal events, with longer denosumab duration associated with higher ONJ risk relative to 6 months or less of treatment.
Why it matters: In this claims based study, longer denosumab duration tracked with more ONJ but fewer skeletal events, raising the question of how to balance these risks; claims data lack details like oral health status.
Limitation: Retrospective claims-based cohort using a target trial emulation; claims data lack some clinical granularity such as oral health status.
Source: JAMA Netw Open · PubMed 42905706 · DOI 10.1001/jamanetworkopen.2026.39765
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