TY - JOUR
T1 - Bone fracture risk is not associated with the use of glucagon-like peptide-1 receptor agonists
T2 - A population-based cohort analysis
AU - Driessen, Johanna H M
AU - Henry, Ronald M A
AU - van Onzenoort, Hein A W
AU - Lalmohamed, Arief
AU - Burden, Andrea M.
AU - Prieto-Alhambra, Daniel
AU - Neef, Cees
AU - Leufkens, Hubert G M
AU - de Vries, Frank
PY - 2015/4/17
Y1 - 2015/4/17
N2 - Glucagon-like Peptide-1 receptor agonists (GLP1-ra) are a relatively new class of anti-hyperglycemic drugs which may positively affect bone metabolism and thereby decrease (osteoporotic) bone fracture risk. Data on the effect of GLP1-ra on fracture risk are scarce and limited to clinical trial data only. The aim of this study was to investigate, in a population-based cohort, the association between the use of GLP1-ra and bone fracture risk. We conducted a population-based cohort study, with the use of data from the Clinical Practice Research Datalink (CPRD) database (2007–2012). The study population (N = 216,816) consisted of all individuals with type 2 diabetes patients with at least one prescription for a non-insulin anti-diabetic drug and were over 18 years of age. Cox proportional hazards models were used to estimate the hazard ratio of fracture in GLP1-ra users versus never-GLP1-ra users. Time-dependent adjustments were made for age, sex, lifestyle, comorbidity and the use of other drugs. There was no decreased risk of fracture with current use of GLP1-ra compared to never- GLP1-ra use (adjusted HR 0.99, 95 % CI 0.82–1.19). Osteoporotic fracture risk was also not decreased by current GLP1-ra use (adjusted HR 0.97; 95 % CI 0.72–1.32). In addition, stratification according to cumulative dose did not show a decreased bone fracture risk with increasing cumulative GLP1-ra dose. We showed in a population-based cohort study that GLP1-ra use is not associated with a decreased bone fracture risk compared to users of other antihyperglycemic drugs. Future research is needed to elucidate the potential working mechanisms of GLP1-ra on bone.
AB - Glucagon-like Peptide-1 receptor agonists (GLP1-ra) are a relatively new class of anti-hyperglycemic drugs which may positively affect bone metabolism and thereby decrease (osteoporotic) bone fracture risk. Data on the effect of GLP1-ra on fracture risk are scarce and limited to clinical trial data only. The aim of this study was to investigate, in a population-based cohort, the association between the use of GLP1-ra and bone fracture risk. We conducted a population-based cohort study, with the use of data from the Clinical Practice Research Datalink (CPRD) database (2007–2012). The study population (N = 216,816) consisted of all individuals with type 2 diabetes patients with at least one prescription for a non-insulin anti-diabetic drug and were over 18 years of age. Cox proportional hazards models were used to estimate the hazard ratio of fracture in GLP1-ra users versus never-GLP1-ra users. Time-dependent adjustments were made for age, sex, lifestyle, comorbidity and the use of other drugs. There was no decreased risk of fracture with current use of GLP1-ra compared to never- GLP1-ra use (adjusted HR 0.99, 95 % CI 0.82–1.19). Osteoporotic fracture risk was also not decreased by current GLP1-ra use (adjusted HR 0.97; 95 % CI 0.72–1.32). In addition, stratification according to cumulative dose did not show a decreased bone fracture risk with increasing cumulative GLP1-ra dose. We showed in a population-based cohort study that GLP1-ra use is not associated with a decreased bone fracture risk compared to users of other antihyperglycemic drugs. Future research is needed to elucidate the potential working mechanisms of GLP1-ra on bone.
KW - Cohort study
KW - CPRD
KW - Diabetes mellitus type 2
KW - Fracture
KW - GLP1-ra
UR - http://www.scopus.com/inward/record.url?scp=84943361982&partnerID=8YFLogxK
U2 - 10.1007/s00223-015-9993-5
DO - 10.1007/s00223-015-9993-5
M3 - Article
C2 - 25894068
AN - SCOPUS:84943361982
SN - 0171-967X
VL - 97
SP - 104
EP - 112
JO - Calcified Tissue International
JF - Calcified Tissue International
IS - 2
M1 - A006
ER -