Questions on therapy with DPP-4 inhibitors and bone homeostasis

A recent study from Gallagher et al. aimed to investigate the effect of a new depeptidyl-peptidase-4 inhibitor, MK-0626, on bone turnover in a mouse model developing insulin resistance and diabetes (MKR mice). Authors have found that treatment with MK-0626 did not affect either MKR mice fasting glucose or parameters of bone metabolism. These data are not in accordance with previous findings, raising questions on the possible protective effect of depeptidyl-peptidase-4 inhibitors on bone loss. Given the negative effects on the bone caused by some antidiabetic drugs, results from this study may be disappointing, but a neutral effect on the bone is still reassuring. However, some aspects of this study should be considered in order to explain these results, and more studies are needed to better understand the effect of this class of drugs on the bone health in humans.