A new review of research on common osteoporosis drugs finds that current studies do not support a clear or consistent effect on heart-related outcomes. The review looked at bisphosphonates, denosumab, and romosozumab, and their potential links to coronary risk and vascular calcification.
For bisphosphonates and denosumab, the evidence suggests they remain biologically relevant to vascular calcification, but no reproducible effect on coronary-specific outcomes was found. However, romosozumab still has unresolved cardiovascular safety questions linked to its mechanism of action.
The review had several limitations. Studies used different definitions of heart outcomes, often inferred coronary risk indirectly, and struggled to translate biological plausibility into real-world effects. Differences in patient populations and baseline risk also made comparisons difficult.
Overall, the evidence does not support a uniform heart effect from osteoporosis drugs. Any vascular consequences appear to be drug-specific and depend on patient factors. Readers should not change their medication based on this review alone and should discuss any concerns with their doctor.