T2D: No evidence to suggest increased fracture risk with DPP-4i, GLP-1 RA, and SGLT-2i

Key clinical point: Dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1 RA), and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) did not increase the risk for fracture in patients with type 2 diabetes (T2D) compared with other antidiabetic agents or placebo.

Major finding: DPP-4i was not associated with a higher risk for total fracture compared with insulin (odds ratio [OR] 0.86; 95% CI 0.39-1.90), metformin (OR 1.41; 95% CI 0.48-4.19), sulfonylureas (OR 0.77; 95% CI 0.50-1.20), thiazolidinediones (OR 0.82; 95% CI 0.27-2.44), α-glucosidase inhibitor (OR 4.92; 95% CI 0.23-103.83), and placebo (OR 1.04; 95% CI 0.84-1.29), with findings being similar for GLP-1 RA and SGLT-2i.

Study details: The data come from a systematic review and network meta-analysis of 177 randomized controlled trials including 165,081 patients with T2D.

Disclosures: This study was supported by the National Natural Science Foundation, China, and others. The authors declared no conflicts of interest.

Source: Chai S et al. Risk of fracture with dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, or sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes mellitus: A systematic review and network meta-analysis combining 177 randomized controlled trials with a median follow-up of 26 weeks. Front Pharmacol. 2022;13:825417 (Jul 1). Doi:  10.3389/fphar.2022.825417

Key clinical point: Dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1 RA), and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) did not increase the risk for fracture in patients with type 2 diabetes (T2D) compared with other antidiabetic agents or placebo.

Major finding: DPP-4i was not associated with a higher risk for total fracture compared with insulin (odds ratio [OR] 0.86; 95% CI 0.39-1.90), metformin (OR 1.41; 95% CI 0.48-4.19), sulfonylureas (OR 0.77; 95% CI 0.50-1.20), thiazolidinediones (OR 0.82; 95% CI 0.27-2.44), α-glucosidase inhibitor (OR 4.92; 95% CI 0.23-103.83), and placebo (OR 1.04; 95% CI 0.84-1.29), with findings being similar for GLP-1 RA and SGLT-2i.

Study details: The data come from a systematic review and network meta-analysis of 177 randomized controlled trials including 165,081 patients with T2D.

Disclosures: This study was supported by the National Natural Science Foundation, China, and others. The authors declared no conflicts of interest.

Source: Chai S et al. Risk of fracture with dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, or sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes mellitus: A systematic review and network meta-analysis combining 177 randomized controlled trials with a median follow-up of 26 weeks. Front Pharmacol. 2022;13:825417 (Jul 1). Doi:  10.3389/fphar.2022.825417

Key clinical point: Dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1 RA), and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) did not increase the risk for fracture in patients with type 2 diabetes (T2D) compared with other antidiabetic agents or placebo.

Major finding: DPP-4i was not associated with a higher risk for total fracture compared with insulin (odds ratio [OR] 0.86; 95% CI 0.39-1.90), metformin (OR 1.41; 95% CI 0.48-4.19), sulfonylureas (OR 0.77; 95% CI 0.50-1.20), thiazolidinediones (OR 0.82; 95% CI 0.27-2.44), α-glucosidase inhibitor (OR 4.92; 95% CI 0.23-103.83), and placebo (OR 1.04; 95% CI 0.84-1.29), with findings being similar for GLP-1 RA and SGLT-2i.

Study details: The data come from a systematic review and network meta-analysis of 177 randomized controlled trials including 165,081 patients with T2D.

Disclosures: This study was supported by the National Natural Science Foundation, China, and others. The authors declared no conflicts of interest.

Source: Chai S et al. Risk of fracture with dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, or sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes mellitus: A systematic review and network meta-analysis combining 177 randomized controlled trials with a median follow-up of 26 weeks. Front Pharmacol. 2022;13:825417 (Jul 1). Doi:  10.3389/fphar.2022.825417