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Br J Clin Pharmacol. 2017 Apr;83(4):923-926. doi: 10.1111/bcp.13167. Epub 2016 Dec 7.

The use of incretins and fractures - a meta-analysis on population-based real life data.

Author information

1
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, the Netherlands.
2
Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+, Maastricht, the Netherlands.
3
Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, the Netherlands.
4
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
5
Department of Pharmacy, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
6
Department of Internal Medicine, Maastricht University Medical Centre+, The Netherlands.
7
Biomedical Research Institute, University Hasselt, Hasselt, Belgium.
8
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
9
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
10
Department of Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.
11
Cardiovascular Research Institute, Maastricht University Medical Centre+, Maastricht, the Netherlands.

Abstract

The aim of the present study was to estimate the effect of incretins on fracture risk in the real-world situation by meta-analysis of the available population-based cohort data. Pubmed and Embase were searched for original articles investigating use of incretin agents, and fracture risk up to December 2015. Adjusted results were extracted and pooled by use of generic inverse variance methods, assuming a random-effects model. Neither current dipeptidyl peptidase 4-inhibitor use nor current glucagon-like peptide 1 receptor agonist use was associated with a decreased risk of fracture: pooled relative risk (pooled RR [95% confidence interval]: 1.02 [0.91-1.13] and 1.03 [0.87-1.22]), respectively. This meta-analysis demonstrated that current use of incretin agents, was not associated with decreased fracture risk. Our findings show the value of representative real-world populations, and the risks associated with suggesting benefits for medications on the basis of safety reporting in randomized controlled trials.

KEYWORDS:

dipeptidyl peptidase 4-inhibitors; fracture; glucagon-like peptide 1-receptor agonists; incretin agents; meta-analysis

PMID:
27780288
PMCID:
PMC5346876
DOI:
10.1111/bcp.13167
[Indexed for MEDLINE]
Free PMC Article

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