SGLT2 Inhibitor Use Not Tied to Increased Fracture Risk in CKD

WEDNESDAY, June 1, 2022 (HealthDay News) -- For older adults, initiation of a sodium-glucose cotransporter-2 (SGLT2) inhibitor is not associated with higher fracture risk compared with initiation of a dipeptidyl peptidase-4 (DPP-4) inhibitor, according to a study published online May 26 in the Clinical Journal of the American Society of Nephrology.

Andrea Cowan, M.D., from the Institute for Clinical and Evaluative Sciences in London, Ontario, Canada, and colleagues conducted a population-based cohort study to compare the incidence of fracture between new users of SGLT2 inhibitors and DPP-4 inhibitors. Inverse probability of treatment weighting on the basis of propensity scores was used to balance the two groups of older adults (66 years of age or older) on indicators of baseline health. The 180- and 365-day cumulative incidence rates of fracture were compared between the groups.

A total of 38,994 new users of an SGLT2 inhibitor and 37,449 new users of a DPP-4 inhibitor were identified after weighting; there were 342 fractures at 180 days and 689 at 365 days. The researchers found that the weighted 180- and 365-day risks for a fragility fracture were not significantly different between the groups. There was no interaction observed between fracture risk and the category of estimated glomerular filtration rate.

"This study reassures patients and doctors that SGLT-2 inhibitors are not associated with an increased risk of fracture in patients with chronic kidney disease," Cowan said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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