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Calcif Tissue Int. 2015 Nov;97(5):506-15. doi: 10.1007/s00223-015-0037-y. Epub 2015 Jul 17.

Use of Glucagon-Like-Peptide 1 Receptor Agonists and Risk of Fracture as Compared to Use of Other Anti-hyperglycemic Drugs.

Author information

1
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
2
Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands.
3
Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
4
Department of Pharmacy, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
5
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
6
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
7
Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
8
Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands.
9
Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.
10
Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands.
11
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
12
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands. f.devries@uu.nl.
13
Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands. f.devries@uu.nl.
14
Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, The Netherlands. f.devries@uu.nl.
15
MRC Epidemiology Lifecourse Unit, Southampton General Hospital, Southampton, UK. f.devries@uu.nl.

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a new class of drugs that might have a potential beneficial effect on bone metabolism. Data on the effect of GLP-1 RAs and fracture risk are lacking. The aim of the present study was to investigate the association between the use of GLP-1 and the risk of fracture. A case-control study was performed using Danish National Health Service data. Cases were those who sustained a fracture and controls were those without a fracture during the study period (2007-2011), all aged 18 years and above. Conditional logistic regression estimated the odds ratios (OR) of fracture with current use of DPP4-I use. Analyses were adjusted for comorbidities and recent drug use. Among cases (n = 229,114), there were 6993 current non-insulin anti-diabetic drug (NIAD) users (excluding incretin users) and 255 GLP-1 RA users. Similarly, among controls (n = 229,114), 7209 were NIAD users (excluding incretin users) and 220 were GLP-1 RA users. Current GLP-1 RA use was not associated with a decreased risk of fracture [adjusted (adj.) OR 1.16; 95% CI 0.83-1.63]. Osteoporotic fracture risk was also not associated with current GLP-1 RA use (adj. OR 0.78; 95% CI 0.44-1.39). In our nation-wide case-control study, we identified that the use of GLP-1 RA was not associated with fracture risk as compared to the use of other anti-hyperglycemic drugs. Additionally, current GLP-1 RA use, stratified by cumulative or average daily dose, is not associated with fracture risk. Further research should focus on long-term use of GLP-1 RA and fracture risk.

KEYWORDS:

Case–control; Fracture; GLP-1 RA; Type 2 diabetes mellitus

PMID:
26184119
PMCID:
PMC4598352
DOI:
10.1007/s00223-015-0037-y
[Indexed for MEDLINE]
Free PMC Article

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