RANKL Inhibition and the Risk of Ocular Hypertension and Primary Open-Angle Glaucoma.

ObservationalInvestigative ophthalmology & visual science· Jun 2026

RANKL Inhibition and the Risk of Ocular Hypertension and Primary Open-Angle Glaucoma.

Chien-Yun Tsai, Chien-Hsiang Weng, Yi Jing Sheen … Chien-Chih Chou

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GlaucomaObservationalQ1IF 4.2

Denosumab use was associated with a significantly lower risk of primary open-angle glaucoma.

RANKL Inhibition and the Risk of Ocular Hypertension and Primary Open-Angle Glaucoma.

Chien-Yun Tsai … Chien-Chih Chou

Investigative ophthalmology & visual science · Jun 2026 · Q1 in Ophthalmology

Purpose

To investigate whether the receptor activator of NF-κB ligand (RANKL) inhibitor denosumab is associated with a lower risk of developing ocular hypertension (ocular hypertension) and primary open-angle glaucoma (primary open-angle glaucoma) compared with bisphosphonate therapy in patients with osteoporosis.

Methods

We conducted a multinational, retrospective cohort study using the TriNetX network from 2013 to 2023.

n = 94,624 patients

Results

denosumab was associated with a lower risk of developing glaucoma

HR by subgroup · 95% CI

More results

These associations remained robust across all sensitivity analyses and were consistently observed across major patient subgroups.

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Conclusion · 1 of 2

Among adults with osteoporosis, denosumab use was associated with significantly lower risks of ocular hypertension and primary open-angle glaucoma compared with bisphosphonate therapy.

Conclusion · 2 of 2

These findings highlight the potential ocular relevance of RANKL inhibition and support further investigation into its clinical implications through prospective studies.

RANKL Inhibition and the Risk of Ocular Hypertension and Primary Open-Angle Glaucoma.

RANKL Inhibition and the Risk of Ocular Hypertension and Primary Open-Angle Glaucoma.

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