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Januvia unlikely to contribute to fracture risk
Osteoporotic fractures in type 2 diabetes are not uncommon, but new use of the DDP-IV inhibitor Januvia is not associated with fracture, according to study results.
Researchers wrote that other commonly used second-line agents for the treatment of type 2 diabetes are linked to increased fracture risk.
Sumit R. Majumdar, MD, MPH, FRCPC, FACP, professor in the department of medicine at the University of Alberta in Canada, and colleagues evaluated data from a U.S. claims database on 72,738 patients with type 2 diabetes (median age, 52 years; median HbA1c, 7.5%) to determine the link between new use of Januvia (sitagliptin, Merck) and major osteoporotic fractures.
Participants were new users of sitagliptin (n = 8,894) or nonusers (n = 63,844); follow-up was conducted for a median of 2 years.
Eighty-six percent of the sitagliptin users were also on metformin.
Overall, there were 741 major osteoporotic fractures yielding an incidence rate of 4.1 fractures per 1,000 person-years. Sitagliptin users experienced 4.8 fractures per 1,000 person-years compared with four fractures per 1,000 person-years for nonusers (P = .3 for the difference). No link was found between sitagliptin and fracture risk, and no independent link existed between current metformin use and fracture.
Increased risks for fracture were found with use of insulin (P < .001), sulfonylureas (P < .001) and thiazolidinediones (P = .019).
“These differential effects on bone health and fracture risk should be considered when making treatment decisions in patients with type 2 diabetes who might be at particularly high risk of osteoporosis-related fractures,” the researchers wrote. – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.