Use of glucagon-like peptide-1 receptor agonists and bone fractures: A meta-analysis of randomized clinical trials

BackgroundPatients with type 2 diabetes mellitus (T2DM) are at a higher risk of bone fractures independent of the use of antidiabetic medications. Furthermore, antidiabetic medications could directly affect bone metabolism. Recently, the use of dipeptidyl peptidase-4 inhibitors has been associated with a lower rate of bone fracture. The aim of the present meta-analysis was to assess whether patients with T2DM treated with glucagon-like peptide-1 receptor agonists (GLP-1Ra) present a lower incidence of bone fracture compared with patients using other antidiabetic drugs. MethodsA search on Medline, Embase, and , as well as a manual search for randomized clinical trials of T2DM treated with either a GLP-1Ra or another antidiabetic drug for a duration of 24 weeks was conducted by two authors (GM, AM) independently. ResultsAlthough 28 eligible studies were identified, only seven trials reported the occurrence of at least a bone fracture in one arm of the trial. The total number of fractures was 19 (13 and six with GLP-1Ra and comparator, respectively). The pooled Mantel-Haenszel odds ratio for GLP-1Ra was 0.75 (95% confidence interval 0.28-2.02, P=0.569) in trials versus other antidiabetic agents. ConclusionsAlthough preliminary, our study highlighted that the use of GLP-1Ra does not modify the risk of bone fracture in T2DM compared with the use of other antidiabetic medications. ?? ??2?????????????,?????????????,?????????????????,??????????-4???????????????meta????????????????????,???????????-1?????(glucagon-like peptide-1 receptor agonists, GLP-1Ra)???2???????????????????? ???????(GM,AM)????Medline?Embase???????????????GLP-1Ra???????????? 24??2??????????? ????????28??????,????7????????????????????????????????19?(GLP-1Ra????????13??6?)??????,??????????,GLP-1Ra??????Mantel-Haenszel????0.75(95%?????0.28-2.02,P = 0.569)? ?????????????,?????????????????????????,??GLP-1Ra????T2DM????????