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DPP-4 inhibitor therapy and bone fractures in people with Type 2 diabetes - A systematic review and meta-analysis

Jil Mamza1, Carol Marlin1, Cai Wang1

  • 1Division of Medical Sciences & Graduate Entry Medicine, University of Nottingham, UK.

Diabetes Research and Clinical Practice
|June 21, 2016
PubMed
Abstract

Insights

Dipeptidyl peptidase-4 (DPP-4) inhibitors do not significantly increase fracture risk in Type 2 diabetes patients. This meta-analysis of 51 RCTs found no association between DPP-4 inhibitor use and fracture incidence compared to placebo or active comparators.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Bone Health

Background:

  • Older adults with Type 2 Diabetes Mellitus (T2DM) face elevated fracture risk.
  • Oral glucose-lowering medications can impact bone metabolism differently.
  • Understanding the skeletal effects of T2DM treatments is crucial for patient care.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials (RCTs).
  • To determine the effect of dipeptidyl peptidase-4 (DPP-4) inhibitors on fracture risk in T2DM patients.
  • To compare fracture incidence between DPP-4 inhibitor users and placebo or active comparator groups.

Main Methods:

  • Comprehensive literature search across EMBASE, MEDLINE, EMA, and WHO ICTRP databases.
  • Inclusion of RCTs comparing DPP-4 inhibitors with placebo or active comparators in T2DM patients.
  • Meta-analysis of fracture events as the primary outcome measure.

Main Results:

  • Analysis included 51 RCTs with 36,402 participants.
  • No significant association was found between DPP-4 inhibitor use and fracture events versus placebo (OR: 0.82; 95% CI: 0.57-1.16).
  • No significant association was observed when compared against active comparators (OR: 1.59; 95% CI: 0.91-2.80).

Conclusions:

  • This meta-analysis provides an updated and comprehensive assessment of DPP-4 inhibitors and fracture risk.
  • Current evidence indicates no significant link between DPP-4 inhibitor use and increased fracture incidence in T2DM.
  • Findings support the safety profile of DPP-4 inhibitors concerning bone health in this population.
Keywords:
Dipeptidyl peptidase-4 inhibitorFractureMeta-analysis

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