The associations of sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors as add-on to metformin with fracture risk in patients with type 2 diabetes mellitus.
Female
Humans
Male
Cohort Studies
Diabetes Mellitus, Type 2
/ complications
Dipeptidyl-Peptidase IV Inhibitors
/ adverse effects
Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
/ metabolism
Fractures, Bone
/ epidemiology
Glucose
/ therapeutic use
Hypoglycemic Agents
/ adverse effects
Metformin
/ adverse effects
Retrospective Studies
Sodium
Sodium-Glucose Transporter 2 Inhibitors
/ adverse effects
DPP-4 inhibitor
SGLT2 inhibitor
cohort study
diabetes complications
pharmacoepidemiology
type 2 diabetes
Journal
Diabetes, obesity & metabolism
ISSN: 1463-1326
Titre abrégé: Diabetes Obes Metab
Pays: England
ID NLM: 100883645
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
revised:
28
06
2023
received:
23
05
2023
accepted:
02
07
2023
medline:
4
10
2023
pubmed:
28
7
2023
entrez:
28
7
2023
Statut:
ppublish
Résumé
To investigate whether sodium-glucose cotransporter-2 (SGLT2) inhibitor use as compared to dipeptidyl peptidase-4 (DPP-4) inhibitor use as add-on to metformin is associated with the risk of any fracture or major osteoporotic fractures (MOFs). A cohort study using the Clinical Practice Research Datalink (CPRD) Aurum database was conducted. All patients aged 18 years and older with a first-ever prescription for a DPP-4 inhibitor or an SGLT2 inhibitor as add-on to metformin between January 1, 2013 and June 30, 2020 were selected. Patients starting with SGLT2 inhibitors were matched (up to 1:3) on propensity scores to patients starting with DPP-4 inhibitors. Propensity scores were calculated based on sex, age, body mass index, comorbidities, comedication and lifestyle factors. Cox proportional hazard models were used to estimate the risk of fracture with SGLT2 inhibitor use as compared to DPP-4 inhibitor use. A total of 13 807 SGLT2 inhibitor users (age 55.4 ± 10.6 years, 36.7% female) were included in this study, matched with 28 524 DPP-4 inhibitor users (age 55.4 ± 8.0 years, 36.4% female). The risk of any fracture with current SGLT2 inhibitor use was similar compared with current DPP-4 inhibitor use (adjusted hazard ratio [aHR] 1.09, 95% confidence interval [CI] 0.91-1.31), as was the risk of MOFs (aHR 0.89, 95% CI 0.64-1.22) and the risk of fractures at any of the individual MOF sites. Additionally, no association was found with duration of SGLT2 inhibitor use (longest duration >811 days) for any of the individual SGLT2 inhibitor agents, or after stratification by sex and age. Use of SGLT2 inhibitors was not associated with the risk of any fracture, MOFs or fracture at the individual MOF sites when compared to DPP-4 inhibitor use.
Substances chimiques
Dipeptidyl-Peptidase IV Inhibitors
0
Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
EC 3.4.14.-
Glucose
IY9XDZ35W2
Hypoglycemic Agents
0
Metformin
9100L32L2N
Sodium
9NEZ333N27
Sodium-Glucose Transporter 2 Inhibitors
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3235-3247Informations de copyright
© 2023 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
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