Common osteoporosis treatments could reduce incidence of COVID-19

Some of the principal treatments for osteoporosis, denosumab, zoledronate and calcium could have a protective effect against COVID-19 in patients, says a new study.

The researchers, from the Hospital del Mar Medical Research Institute (IMIM), Pompeu Fabra University and the Pere Virgili Health Park, say the treatments could result in a 30 to 40 percent reduction in the rate of COVID-19 infection.

The last author of the study, Dr Jordi Monfort, explained that “there are indications to allow hypothesising that certain drugs used to treat rheumatic diseases could interfere positively in the natural history of COVID-19, either by decreasing its incidence or by decreasing its progression to more serious cases.”

The study analysed data from more than 2,000 patients with osteoporosis, osteoarthritis and fibromyalgia and their relationship with COVID-19 infection who are being followed up at Hospital del Mar and in the Mar Health Park healthcare sphere of influence.

Researchers at the Hospital del Mar saw a low incidence of the pandemic in some of their patients. This led them to study the different treatments and the evolution of rheumatology patients with non-inflammatory diseases and their relation to infection by SARS-CoV-2, their evolution, need for hospitalisation and mortality.

“The study suggests that some of these treatments may protect patients against infection by COVID-19, although further studies still need to be conducted on more patients to prove it,” said Dr Josep Blanch-Rubio, first author of the study.

The team say that in the case of denosumab, the drug targets the RANK/RANKL system involved in the balance of the skeletal system, but also the response by the immune system through the activation and differentiation of some of its cells. Its inhibition modifies the inflammatory response and acts on cytokines, which play a key role in infection by COVID-19. Zoledronate can also modulate the immune response and can stimulate its activity against SARS-CoV-2.

The results also indicate that another common treatment for these patients, the antidepressant duloxetine, may also have a positive effect in reducing the incidence of COVID-19. Conversely, a commonly used painkiller, pregabalin, seems to have a tendency to increase the incidence of the disease.

In view of these findings, Dr Rafael Maldonado, study reference author said that “these antiosteoporotic drugs are safe and should continue to be administered to patients who take them. The promising results obtained with duloxetine are significant.”

Dr Alba Gurt, co-author of the study, said that “the data from the study would indicate that the antiosteoporotic treatments and duloxetine administered to our primary care patients are safe against infection by COVID-19 and could even reduce its incidence. However, studies with a higher number of patients are required to verify this.”

The study was published the journal Aging.