caa a22 4500 605520968 CHVBK 20210128100738.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00223-015-9993-5 doi (NATIONALLICENCE)springer-10.1007/s00223-015-9993-5 Bone Fracture Risk is Not Associated with the Use of Glucagon-Like Peptide-1 Receptor Agonists: A Population-Based Cohort Analysis [Elektronische Daten] [Johanna Driessen, Ronald Henry, Hein van Onzenoort, Arief Lalmohamed, Andrea Burden, Daniel Prieto-Alhambra, Cees Neef, Hubert Leufkens, Frank de Vries] Glucagon-like Peptide-1 receptor agonists (GLP1-ra) are a relatively new class of anti-hyperglycemic drugs which may positively affect bone metabolism and thereby decrease (osteoporotic) bone fracture risk. Data on the effect of GLP1-ra on fracture risk are scarce and limited to clinical trial data only. The aim of this study was to investigate, in a population-based cohort, the association between the use of GLP1-ra and bone fracture risk. We conducted a population-based cohort study, with the use of data from the Clinical Practice Research Datalink (CPRD) database (2007-2012). The study population (N=216,816) consisted of all individuals with type 2 diabetes patients with at least one prescription for a non-insulin anti-diabetic drug and were over 18years of age. Cox proportional hazards models were used to estimate the hazard ratio of fracture in GLP1-ra users versus never-GLP1-ra users. Time-dependent adjustments were made for age, sex, lifestyle, comorbidity and the use of other drugs. There was no decreased risk of fracture with current use of GLP1-ra compared to never-GLP1-ra use (adjusted HR 0.99, 95% CI 0.82-1.19). Osteoporotic fracture risk was also not decreased by current GLP1-ra use (adjusted HR 0.97; 95% CI 0.72-1.32). In addition, stratification according to cumulative dose did not show a decreased bone fracture risk with increasing cumulative GLP1-ra dose. We showed in a population-based cohort study that GLP1-ra use is not associated with a decreased bone fracture risk compared to users of other anti-hyperglycemic drugs. Future research is needed to elucidate the potential working mechanisms of GLP1-ra on bone. The Author(s), 2015 GLP1-ra nationallicence Fracture nationallicence Diabetes mellitus type 2 nationallicence Cohort study nationallicence CPRD nationallicence Driessen Johanna Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands aut Henry Ronald Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands aut van Onzenoort Hein Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, The Netherlands aut Lalmohamed Arief Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands aut Burden Andrea Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands aut Prieto-Alhambra Daniel Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK aut Neef Cees Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands aut Leufkens Hubert Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands aut de Vries Frank Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands aut Calcified Tissue International Springer US; http://www.springer-ny.com 97/2(2015-08-01), 104-112 0171-967X 97:2<104 2015 97 223 https://doi.org/10.1007/s00223-015-9993-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00223-015-9993-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Driessen Johanna Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Henry Ronald Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands aut NATIONALLICENCE 700 1- van Onzenoort Hein Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre+, Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Lalmohamed Arief Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Burden Andrea Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Prieto-Alhambra Daniel Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK aut NATIONALLICENCE 700 1- Neef Cees Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Leufkens Hubert Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- de Vries Frank Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands aut NATIONALLICENCE 773 0- Calcified Tissue International Springer US; http://www.springer-ny.com 97/2(2015-08-01), 104-112 0171-967X 97:2<104 2015 97 223