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Use of dipeptidyl peptidase 4 inhibitors and fracture risk compared to use of other anti‐hyperglycemic drugs
Author(s) -
Driessen Johanna H. M.,
Onzenoort Hein A. W.,
StarupLinde Jakob,
Henry Ronald,
Neef Cees,
Bergh Joop,
Vestergaard Peter,
Vries Frank,
Burden Andrea M.
Publication year - 2015
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.3837
Subject(s) - medicine , pharmacoepidemiology , dipeptidyl peptidase 4 , odds ratio , incretin , diabetes mellitus , type 2 diabetes , pharmacology , endocrinology , medical prescription
Dipeptidyl 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. Methods A 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 18 years 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. Results Among 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. Conclusions In 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 © 2015 John Wiley & Sons, Ltd.