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06.08.2018 | Original Article | Ausgabe 12/2018

Osteoporosis International 12/2018

Glucagon-like peptide-1 receptor agonists and fracture risk: a network meta-analysis of randomized clinical trials

Zeitschrift:
Osteoporosis International > Ausgabe 12/2018
Autoren:
Y. S. Zhang, W. Y. Weng, B. C. Xie, Y. Meng, Y. H. Hao, Y. M. Liang, Z. K. Zhou
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00198-018-4649-8) contains supplementary material, which is available to authorized users.
Y. S. Zhang, W. Y. Weng and B. C. Xie contributed equally to this work.

Abstract

Summary

Our network meta-analysis analyzed the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on fracture risk. By combining data from randomized controlled trials, we found that GLP-1 RAs were associated with a decreased bone fracture risk, and exenatide is the best option agent with regard to the risk of fracture. This study is registered with PROSPERO (CRD42018094433).

Introduction

Data on the effects of GLP-1 RAs on fracture risk are conflicted. This study aimed to analyze the available evidence on the effects of GLP-1 RAs on fracture risk in type 2 diabetes mellitus patients.

Methods

Electronic databases were searched for relevant published articles, and unpublished studies presented at ClinicalTrials.​gov were searched for relevant clinical data. All analyses were performed with STATA 12.0 and R software (Version 3.4.4). We estimated the risk ratio (RR) and 95% confidence interval (CI) by combining RRs for fracture effects of included trials.

Results

There were 54 eligible random control trials (RCTs) with 49,602 participants, including 28,353 patients treated with GLP-1 RAs. Relative to placebo, exenatide (RR, 0.17; 95% CI 0.03–0.67) was associated with lowest risk of fracture among other GLP-1 RAs. Exenatide had the highest probability to be the safest option with regard to the risk of fracture (0.07 ‰), followed by dulaglutide (1.04%), liraglutide (1.39%), albiglutide (5.61%), lixisenatide (8.07%), and semaglutide (18.72%). A statistically significant inconsistency was observed in some comparisons.

Conclusion

The Bayesian network meta-analysis suggests that GLP-1 RAs were associated with a decreased bone fracture risk compared to users of placebo or other anti-hyperglycemic drugs in type 2 diabetes mellitus patients, and exenatide is the best option agent with regard to the risk of fracture.

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Zusatzmaterial
ESM 1 (DOCX 36 kb)
198_2018_4649_MOESM1_ESM.docx
Literatur
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