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No Increased Fracture Risk With Canagliflozin in Type 2 Diabetes

Rate of the primary outcome was similar for canagliflozin, glucagon-like peptide-1 agonist

WEDNESDAY, Jan. 2, 2019 (HealthDay News) — Canagliflozin is not associated with increased fracture risk versus glucagon-like peptide-1 (GLP-1) agonists for middle-aged patients with type 2 diabetes, according to a study published online Jan. 1 in the Annals of Internal Medicine.

Michael Fralick, M.D., from Brigham and Women’s Hospital in Boston, and colleagues estimated the risk for nonvertebral fracture among new users of canagliflozin versus a GLP-1 agonist using data from two commercial health care databases containing data on more than 70 million patients. A total of 79,964 patients with type 2 diabetes who initiated canagliflozin were propensity score-matched to 79,964 patients initiating GLP-1 agonist use (mean age, 55 years).

The researchers found that the primary outcome (composite end point of humerus, forearm, pelvis, or hip fracture requiring intervention) was similar for canagliflozin and GLP-1 agonists (2.2 and 2.3 events, respectively, per 1,000 person-years), with an overall hazard ratio of 0.98 (95 percent confidence interval, 0.75 to 1.26). They observed a similar risk for pelvic, hip, humerus, radius, ulna, carpal, metacarpal, metatarsal, or ankle fracture for canagliflozin and GLP-1 agonists (14.5 and 16.1 events, respectively, per 1,000 person-years; overall hazard ratio, 0.92; 95 percent confidence interval, 0.83 to 1.02).

“These results should be reassuring to patients and physicians who are considering the potential risks and benefits of canagliflozin,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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