Risk of fracture with dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, or sodium-glucose cotransporter-2 inhibitors in real-world use: systematic review and meta-analysis of observational studies
| العنوان: | Risk of fracture with dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, or sodium-glucose cotransporter-2 inhibitors in real-world use: systematic review and meta-analysis of observational studies |
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| المؤلفون: | Xuan Du, B.-M. Shi, Khemayanto Hidayat |
| المصدر: | Osteoporosis International. 30:1923-1940 |
| بيانات النشر: | Springer Science and Business Media LLC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | 0301 basic medicine, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Risk Assessment, Glucagon-Like Peptide-1 Receptor, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Diabetes mellitus, Humans, Hypoglycemic Agents, Medicine, Sodium-Glucose Transporter 2 Inhibitors, Dipeptidyl peptidase-4, Dipeptidyl-Peptidase IV Inhibitors, Hip fracture, business.industry, medicine.disease, Confidence interval, Observational Studies as Topic, Diabetes Mellitus, Type 2, Relative risk, Meta-analysis, Observational study, 030101 anatomy & morphology, business, Osteoporotic Fractures |
| الوصف: | In the present meta-analysis based on real-world data, the use of dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1ra), or sodium-glucose cotransporter-2 inhibitors (SGLT2i) was not associated with the risk of fracture. Cumulative evidence from randomized control trials (RCTs) with limited fracture events showed that the use of DPP-4i, GLP-1ra, or SGLT2i may not affect the risk of fracture. However, additional insights from large population-based studies with routinely collected data on fracture events and an adequate amount of fracture events are necessary to draw firm conclusions. To refine and complement the results from RCTs, a systematic review and meta-analysis of observational studies were performed to investigate the association between the use of DPP-4i, GLP-1ra, or SGLT2i and the risk of fracture in real-world settings. The PubMed and Web of Science databases were searched to identify relevant observational studies. A random-effect model was used to estimate the summary relative risks (RRs). The use of DPP-4i (RR 0.83, 95% CI [confidence interval] 0.60, 1.14; n = 11), GLP-1ra (RR 0.65, 95% CI 0.24, 1.74; n = 4), or SGLT2i (RR 1.02, 95% CI 0.91, 1.16; n = 4) was not associated with the risk of fracture. In general, there was a consistent lack of association between the use of DPP-4i or GLP-1ra and the risk of fracture across nearly all subgroups, except for a significantly reduced risk of hip fracture with the use of GLP-1ra (RR 0.21, 95% CI 0.04, 0.98). Cumulative real-world evidence does not support an association between the use of DPP-4i, GLP-1ra, or SGLT2i and the risk of fracture. Our findings, together with the cumulative evidence from RCTs, should reassure policy makers and medical practitioners that the use of these medications is unlikely to increase the risk of fracture among type 2 diabetes mellitus patients in general. Further studies need to investigate the long-term impact of these drugs on the fracture risk, particularly in high-risk populations. |
| تدمد: | 1433-2965 0937-941X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d892453d64e768b856c75611a3bacc25Test https://doi.org/10.1007/s00198-019-04968-xTest |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....d892453d64e768b856c75611a3bacc25 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14332965 0937941X |
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