title: The use of incretins and fractures - a meta-analysis on population-based real life data.
abstract: The aim of the present study was to estimate the effect of incretins on fracture risk in the real-world situation by meta-analysis of the available population-based cohort data. Pubmed and Embase were searched for original articles investigating use of incretin agents, and fracture risk up to December 2015. Adjusted results were extracted and pooled by use of generic inverse variance methods, assuming a random-effects model. Neither current dipeptidyl peptidase 4-inhibitor use nor current glucagon-like peptide 1 receptor agonist use was associated with a decreased risk of fracture: pooled relative risk (pooled RR [95% confidence interval]: 1.02 [0.91-1.13] and 1.03 [0.87-1.22]), respectively. This meta-analysis demonstrated that current use of incretin agents, was not associated with decreased fracture risk. Our findings show the value of representative real-world populations, and the risks associated with suggesting benefits for medications on the basis of safety reporting in randomized controlled trials.
authors: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, the Netherlands.|Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+, Maastricht, the Netherlands.|Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, the Netherlands.
authors: Johanna H M
authors: JH
authors: Driessen
authors: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, the Netherlands.|Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+, Maastricht, the Netherlands.|Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, the Netherlands.|MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors: Frank
authors: F
authors: de Vries
authors: 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: Hein
authors: H
authors: van Onzenoort
authors: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors: Nicholas C
authors: NC
authors: Harvey
authors: Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+, Maastricht, the Netherlands.|Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, the Netherlands.
authors: Cees
authors: C
authors: Neef
authors: Department of Internal Medicine, Maastricht University Medical Centre+, The Netherlands.|Biomedical Research Institute, University Hasselt, Hasselt, Belgium.
authors: Joop P W
authors: JP
authors: van den Bergh
authors: Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.|Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
authors: Peter
authors: P
authors: Vestergaard
authors: Department of Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.|Cardiovascular Research Institute, Maastricht University Medical Centre+, Maastricht, the Netherlands.
authors: Ronald M A
authors: RM
authors: Henry
mesh_terms: D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000008:administration & dosage / Q000494:pharmacology; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D054795:Incretins / Q000008:administration & dosage / Q000494:pharmacology; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D054795:Incretins; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
keywords: dipeptidyl peptidase 4-inhibitors; fracture; glucagon-like peptide 1-receptor agonists; incretin agents; meta-analysis