| アブストラクト | AIM: 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). METHODS: 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. RESULTS: 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. CONCLUSION: 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. |
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| 投稿者 | van Hulten, Veerle; Driessen, Johanna H M; Starup-Linde, Jakob K; Al-Mashhadi, Zheer K; Viggers, Rikke; Klungel, Olaf H; Souverein, Patrick C; Vestergaard, Peter; Stehouwer, Coen D A; van den Bergh, Joop P |
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| 組織名 | Department of Clinical Pharmacy and Toxicology, Maastricht University Medical;Centre+ (MUMC+), Maastricht, The Netherlands.;School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht;University, Maastricht, The Netherlands.;Cardiovascular Research Institute Maastricht (CARIM), Maastricht University,;Maastricht, The Netherlands.;Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for;Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.;Department of Endocrinology and Internal Medicine, Aarhus University Hospital,;Aarhus, Denmark.;Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.;Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.;Steno Diabetes Center North Denmark, Aalborg, Denmark.;Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.;Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.;Department of Internal Medicine, Cardiovascular Research Institute Maastricht,;Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands.;Department of Internal Medicine, Division of Rheumatology, Maastricht University;Medical Centre+ (MUMC+), Maastricht, The Netherlands.;Department of Internal Medicine, Subdivision of Endocrinology, VieCuri Medical;Center, Venlo, The Netherlands. |
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