Article ; Online: Time-dependent risk of fracture in adults with type 2 diabetes receiving anti-diabetic drug: A one-stage network meta-analysis.
Diabetes/metabolism research and reviews
2024 Volume 40, Issue 2, Page(s) e3780
Abstract: Aims: To assess the time-dependent risk of fracture in adults with type 2 diabetes receiving anti-diabetic drugs.: Materials and methods: We searched MEDLINE, EMBASE, and Cochrane Library up to 18 November 2021, for randomized controlled trials (RCTs) ...
Abstract | Aims: To assess the time-dependent risk of fracture in adults with type 2 diabetes receiving anti-diabetic drugs. Materials and methods: We searched MEDLINE, EMBASE, and Cochrane Library up to 18 November 2021, for randomized controlled trials (RCTs) and propensity-score-matched non-randomized studies (NRSs) comparing all anti-diabetic drugs with standard treatment or with each other on fracture in adults with type 2 diabetes. The study performed a one-stage network meta-analysis using discrete-time hazard regression with reconstructed individual time-to-event data. Results: This network meta-analysis involved seven RCTs (65,051 adults with type 2 diabetes) with a median follow-up of 36 months and three propensity-score-based NRSs (17,954 participants) with a median follow-up of 27.3 months. Among anti-diabetic drugs, thiazolidinediones increased the overall hazard of fracture by 42% (95% credible interval [CrI], 3%-97%) and almost tripled the risk after 4 years (hazard ratio [HR], 2.74; 95% CrI, 1.53-4.80). Credible subgroup analysis suggested that thiazolidinediones increased the hazard of fracture only in females (HR, 2.19; 95% CrI, 1.26-3.74) but not among males (HR, 0.81; 95% CrI, 0.45-1.40). Moderate certainty evidence established that thiazolidinediones increase 92 fractures in five years per 1000 female patients. We did not find the risk of fractures with other anti-diabetic drugs including metformin, sulfonylureas, sodium-glucose cotransporter-2 (SGLT2) inhibitors, and dipeptidyl peptidase-4 (DPP-4) inhibitors. Conclusions: Long-term use of thiazolidinediones elevates the risk of fracture among females with type 2 diabetes. There is no evidence eliciting fracture risk associated with other anti-diabetic drugs. |
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MeSH term(s) | Male ; Adult ; Female ; Humans ; Hypoglycemic Agents/adverse effects ; Network Meta-Analysis ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/chemically induced ; Dipeptidyl-Peptidase IV Inhibitors/adverse effects ; Fractures, Bone/epidemiology ; Fractures, Bone/etiology ; Fractures, Bone/prevention & control ; Thiazolidinediones/adverse effects |
Chemical Substances | Hypoglycemic Agents ; Dipeptidyl-Peptidase IV Inhibitors ; Thiazolidinediones |
Language | English |
Publishing date | 2024-02-17 |
Publishing country | England |
Document type | Meta-Analysis ; Journal Article |
ZDB-ID | 1470192-3 |
ISSN | 1520-7560 ; 1520-7552 |
ISSN (online) | 1520-7560 |
ISSN | 1520-7552 |
DOI | 10.1002/dmrr.3780 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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