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Sodium-Glucose Co-Transporter 2 Inhibitors and Fracture Risk

Anastasia Erythropoulou-Kaltsidou1, Georgios Polychronopoulos1, Konstantinos Tziomalos2

  • 1First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.

Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders
|November 18, 2019
PubMed

Insights

Sodium-glucose co-transporter-2 (SGLT2) inhibitors may not increase fracture risk in type 2 diabetes patients. Available data are inconclusive, with some studies showing no increased risk for fractures with SGLT2 inhibitors.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Bone Health

Background:

  • Patients with type 2 diabetes mellitus (T2DM) exhibit an elevated risk for fractures.
  • Concerns arose regarding SGLT2 inhibitors potentially increasing fracture risk, based on initial findings from the CANVAS trial.

Purpose of the Study:

  • To review and summarize data on the association between SGLT2 inhibitors and fracture risk in T2DM patients.
  • To evaluate the current evidence regarding the safety of SGLT2 inhibitors concerning bone health.

Main Methods:

  • Review of data from randomized controlled trials (RCTs) involving SGLT2 inhibitors in T2DM patients.
  • Analysis of findings from the CANVAS trial and subsequent large RCTs.

Main Results:

  • Canagliflozin did not increase fracture risk in a recent RCT for diabetic nephropathy, contrasting with earlier CANVAS trial results.
  • Other SGLT2 inhibitors, empagliflozin and dapagliflozin, also do not appear to impact fracture incidence.
  • No clear pathogenetic mechanism has been identified to link SGLT2 inhibitors to increased fracture risk.

Conclusions:

  • Current data are inconclusive to definitively attribute increased fracture risk to SGLT2 inhibitors.
  • Further research may be needed to clarify the relationship between SGLT2 inhibitors and bone health in T2DM.
  • The potential for SGLT2 inhibitors to affect fracture risk remains an area of ongoing investigation.
Keywords:
CanagliflozinDapagliflozinEmpagliflozinFractureSodium-glucose co-transporter-2 inhibitorsType 2 diabetes mellitus

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