| アブストラクト | An increase in fracture risk has been reported in patients with type 2 diabetes mellitus (T2DM) treated with canagliflozin, possibly mediated by effects induced by all members of the sodium-glucose co-transporter-2 (SGLT2) inhibitor class. It is unclear whether initiation of dapagliflozin is followed by an increase in the risk of fracture; therefore, we performed a population-based, open cohort study (from January 2013 to January 2016) using The Health Improvement Network (THIN). A total of 22 618 people with T2DM (4548 exposed to dapagliflozin and 18 070 receiving standard antidiabetic treatment, matched for age, sex, body mass index and diabetes duration) with no history of fractures at baseline were included. The primary outcome was the occurrence of any fragility fracture (hip, spine, wrist) during the observation period. Risk of any fracture served as a secondary outcome. Adjusted hazard rate ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox regression. A total of 289 fractures (132 fragility fractures) were recorded. No difference in the risk of fragility fracture was detected between participants prescribed dapagliflozin and matched control participants (crude HR 0.90, 95% CI 0.59-1.39, P = .645; adjusted HR 0.87, 95% CI 0.56-1.35, P = .531). Similarly, no difference in the risk of any fracture was detected (adjusted HR 0.89, 95% CI 0.66-1.20; P = .427). Sensitivity analyses limited to the subset of the population at high risk of fracture produced similar results; thus, there was no evidence to suggest an increase in the risk of treatment-emergent fractures in patients with T2DM who initiated treatment with dapagliflozin. |
|---|
| ジャーナル名 | Diabetes, obesity & metabolism |
|---|
| Pubmed追加日 | 2017/12/2 |
|---|
| 投稿者 | Toulis, Konstantinos A; Bilezikian, John P; Thomas, G Neil; Hanif, Wasim; Kotsa, Kalliopi; Thayakaran, Rasiah; Keerthy, Deepiksana; Tahrani, Abd A; Nirantharakumar, Krishnarajah |
|---|
| 組織名 | Institute of Applied Health Research, University of Birmingham, Birmingham, UK.;Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece.;Metabolic Bone Diseases Unit, Division of Endocrinology, Department of Medicine,;College of Physicians and Surgeons, Columbia University, New York, New York.;Diabetes Department, University Hospitals Birmingham NHS Foundation Trust,;Birmingham, UK.;First Department of Internal Medicine, Division of Endocrinology & Diabetes;Center, Aristotle University, Thessaloniki, Greece.;Institute of Metabolism and Systems Research, University of Birmingham,;Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners,;Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital,;Birmingham B15 2TT, UK. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/29193543/ |
|---|
