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Sodium‐glucose cotransporter 2 ( SGLT2 ) inhibitors and fracture risk in patients with type 2 diabetes mellitus: A meta‐analysis
Author(s) -
Ruanpeng Darin,
Ungprasert Patompong,
Sangtian Jutarat,
Harindhanavudhi Tasma
Publication year - 2017
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2903
Subject(s) - dapagliflozin , empagliflozin , canagliflozin , medicine , placebo , confidence interval , type 2 diabetes mellitus , meta analysis , diabetes mellitus , relative risk , randomized controlled trial , type 2 diabetes , gastroenterology , endocrinology , surgery , pathology , alternative medicine
Background Sodium‐glucose cotransporter 2 (SGLT2) inhibitors could potentially alter calcium and phosphate homeostasis and may increase the risk of bone fracture. Methods The current meta‐analysis was conducted to investigate the fracture risk among patients with type 2 diabetes mellitus treated with SGLT2 inhibitors. Randomized controlled trials that compared the efficacy of SGLT2 inhibitors to placebo were identified. The risk ratios of fracture among patients who received SGLT2 inhibitors versus placebo were extracted from each study. Pooled risk ratios and 95% confidence intervals were calculated using a random‐effect, Mantel‐Haenszel analysis. Results A total of 20 studies with 8286 patients treated with SGLT2 inhibitors were included. The pooled risk ratio of bone fracture in patients receiving SGLT2 inhibitors versus placebo was 0.67 (95% confidence interval, 0.42‐1.07). The pooled risk ratio for canagliflozin, dapagliflozin, and empagliflozin was 0.66 (95% confidence interval, 0.37‐1.19), 0.84 (95% confidence interval, 0.22‐3.18), and 0.57 (95% confidence interval, 0.20‐1.59), respectively. Conclusions Increased risk of bone fracture among patients with type 2 diabetes mellitus treated with SGLT2 inhibitors compared with placebo was not observed in this meta‐analysis. However, the results were limited by short duration of treatment/follow‐up and low incidence of the event of interest.