Journal
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
Volume 24, Issue 10, Pages 1017-1025Publisher
WILEY
DOI: 10.1002/pds.3837
Keywords
DPP4-I; fracture; type 2 diabetes mellitus; case-control; pharmacoepidemiology
Funding
- Netherlands Organisation for Health Research and Development (ZonMW)
- Dutch Health Care Insurance Board (CVZ)
- Royal Dutch Pharmacists Association (KNMP)
- EU Innovative Medicines Initiative (IMI)
- EU
- Dutch Ministry of Health and Industry (GlaxoSmithKline)
- Dutch Ministry of Health and Industry (Pfizer)
- Canadian Institutes of Health Research (CIHR)
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IntroductionDipeptidyl peptidase-4 inhibitors (DPP4-Is) are a new class of anti-hyperglycemic drugs which might have a potential beneficial effect on bone metabolism. Data on the effect of DPP4-I use and fracture risk is limited and conflicting. The aim of the present study was to investigate the association between use of DPP4-Is and fracture risk. MethodsA case-control study was conducted using data from the Danish National Health Service. Cases were those who sustained a fracture, and controls were those without a fracture during the study period (2007-2011), all aged 18years and older. Conditional logistic regression estimated the odds ratios of fracture with current use of DPP4-I use. Analyses were adjusted for comorbidities and recent drug use. ResultsAmong the cases there were 6993 current non-insulin anti-diabetic drug (NIAD) users (excluding incretin users) and 643 DPP4-I users. There were 7209 NIAD users (excluding incretin users) among the controls and 707 DPP4-I users. Current DPP4-I use was not associated with risk of any fracture (adjusted [adj.] OR: 0.97, 95% CI: 0.79-1.18) or major osteoporotic fracture (adj. OR: 0.96, 95% CI: 0.72-1.28). Stratification of current DPP4-I use to cumulative and average daily dose did not show an association. ConclusionsIn a population-based case-control study we identified that short-term use of DPP4-I was not associated with fracture risk as compared to users of other anti-hyperglycemic drugs. Additionally, results suggest that increasing daily dose and cumulative DPP4-I exposure were not associated with fracture risk. However, more research is needed to assess the effect of long-term DPP4-I use on the risk of fracture. Copyright (c) 2015 John Wiley & Sons, Ltd.
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