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New research challenges the link between diabetes medication & fractures

Inhibitors of sodium-glucose transporter-2(SGLT2) may be used to control blood sugar in diabetic patients. However, there have been large clinical trials that linked these drugs with a higher chance of bone fracture.
Recent research published in CJASN showed that an SGLT2 antagonist was not associated with a greater risk of fracture than any other diabetes drug. This is regardless of whether the patient has a normal kidney function.
Andrea Cowan, MD (London Health Sciences Centre), conducted the study. She and her coworkers compared fracture rates for adults aged 66+ who were prescribed SGLT-2 inhibits to those who were prescribed dipeptidyl peptidase(DPP-4) inhibitors. This medication has not been associated with fractures. This analysis was done in Ontario, Canada. It included 38,994 new users for an SGLT2 inhibitor, and 37,449 new DPP-4 users. Individuals with severe reduced kidney function were not included in the study.

In total, there were 342 fractures within 180 days and 689 fractures within 365 days. Individuals prescribed an SGLT-2 inhibitor or a DPP-4 inhibit did not have a different fracture risk, both in the whole group and for those with lower kidney function.
Dr. Cowan said, “This study reassures patients as well as doctors that SGLT-2 inhibits are not associated to an increased risk for fracture in patients suffering from chronic kidney disease.”
The study is accompanied by editorial that states, “Additionally, this study adds to the growing body evidence regarding the safety of SGLT2 inhibits. However, it should encourage continued clinical and basic studies to determine their potential risk for fractures, particularly in patients with advanced chronic kidney disease.”
Velcheti is also the director of Perlmutter’s thoracic medical-oncology program. He warns that more results from the ongoing study will have to show similar benefits before nemvaleukinalfa treatment can become a standard of care, or go-to therapy for advanced cancer patients.


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