title: Use of Glucagon-Like-Peptide 1 Receptor Agonists and Risk of Fracture as Compared to Use of Other Anti-hyperglycemic Drugs.
abstract: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a new class of drugs that might have a potential beneficial effect on bone metabolism. Data on the effect of GLP-1 RAs and fracture risk are lacking. The aim of the present study was to investigate the association between the use of GLP-1 and the risk of fracture. A case-control study was performed using Danish National Health Service data. Cases were those who sustained a fracture and controls were those without a fracture during the study period (2007-2011), all aged 18 years and above. Conditional logistic regression estimated the odds ratios (OR) of fracture with current use of DPP4-I use. Analyses were adjusted for comorbidities and recent drug use. Among cases (n = 229,114), there were 6993 current non-insulin anti-diabetic drug (NIAD) users (excluding incretin users) and 255 GLP-1 RA users. Similarly, among controls (n = 229,114), 7209 were NIAD users (excluding incretin users) and 220 were GLP-1 RA users. Current GLP-1 RA use was not associated with a decreased risk of fracture [adjusted (adj.) OR 1.16; 95% CI 0.83-1.63]. Osteoporotic fracture risk was also not associated with current GLP-1 RA use (adj. OR 0.78; 95% CI 0.44-1.39). In our nation-wide case-control study, we identified that the use of GLP-1 RA was not associated with fracture risk as compared to the use of other anti-hyperglycemic drugs. Additionally, current GLP-1 RA use, stratified by cumulative or average daily dose, is not associated with fracture risk. Further research should focus on long-term use of GLP-1 RA and fracture risk.
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.|Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands.|Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Johanna H M
authors.initials: JH
authors.lastname: Driessen
authors.affiliation: Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, The Netherlands.|Department of Pharmacy, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Hein A W
authors.initials: HA
authors.lastname: van Onzenoort
authors.affiliation: Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.|Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Jakob
authors.initials: J
authors.lastname: Starup-Linde
authors.affiliation: Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.|Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Henry
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.|Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands.|Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Burden
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.|Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands.
authors.forename: Cees
authors.initials: C
authors.lastname: Neef
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.|Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands.
authors.forename: Joop P
authors.initials: JP
authors.lastname: van den Bergh
authors.affiliation: Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.|Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Vestergaard
authors.affiliation: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands. f.devries@uu.nl.|Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands. f.devries@uu.nl.|Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, The Netherlands. f.devries@uu.nl.|MRC Epidemiology Lifecourse Unit, Southampton General Hospital, Southampton, UK. f.devries@uu.nl.
authors.forename: Frank
authors.initials: F
authors.lastname: de Vries
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D050723:Fractures, Bone / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D007004:Hypoglycemic Agents; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
keywords: Case–control; Fracture; GLP-1 RA; Type 2 diabetes mellitus