Researchers have found in a new study that adults with osteoporosis who initiated denosumab had a modestly lower risk of developing osteoarthritis compared with those starting oral bisphosphonates. The absolute risk reduction (ARR) and relative risk (RR) estimates were calculated at 3 years using Kaplan–Meier estimators within per-protocol (PP) and intention-to-treat (ITT) analysis approach. Key findings:n the per-protocol new-user comparison, denosumab initiation demonstrated a statistically significant absolute risk reduction (ARR) for incident osteoarthritis of 2.0% (95% confidence interval [CI], 1.1%–3.2%) and a relative risk (RR) of 0.83 (95% CI, 0.73–0.91) compared with oral bisphosphonates. In the intention-to-treat new-user framework, denosumab was similarly associated with an ARR of 1.9% (95% CI, 1.3%–3.3%) and an RR of 0.84 (95% CI, 0.73–0.89). Under ITT analysis, the switch-continue cohort showed a corresponding ARR of 1.2% (95% CI, –0.2% to 2.7%) and an RR of 0.89 (95% CI, 0.77–1.02).