Table 4.
Use of GLP-1 RAs and risk of any fracture stratified by cumulative and average daily dose
| Any fracture | Osteoporotic fracture | |||||
|---|---|---|---|---|---|---|
| No. of cases (N = 229,145)a | No. of controls (N = 229,145)a | Adjusted OR (95 % CI)b | No. of cases (N = 96,774)a | No. of controls (N = 96,774)a | Adjusted OR (95 % CI)c | |
| Current NIAD use excl. incretins | 6993 | 7209 | Reference | 3957 | 4058 | Reference |
| Current GLP-1 RA use | 80 | 71 | 1.16 (0.83–1.63) | 23 | 31 | 0.78 (0.44–1.39) |
| By cumulative exposured | ||||||
| 0–1.4 mg | 36 | 34 | 1.05 (0.63–1.73) | 10 | 17 | 0.64 (0.28–1.47) |
| 1.4–2.7 mg | 14 | 11 | 1.60 (0.69–3.69) | 3 | 5 | 0.57 (0.12–2.74) |
| 2.7–5.5 mg | 12 | 8 | 1.55 (0.60–3.95) | 4 | 2 | 2.05 (0.32–13.30) |
| ≥5.5 mg | 18 | 18 | 0.98 (0.50–1.94) | 6 | 7 | 0.93 (0.30–2.92) |
| By average daily dosed | ||||||
| <15 mcg/day | 16 | 19 | 0.91 (0.47–1.84) | 3 | 9 | 0.35 (0.09–1.39) |
| 15–22.49 mcg/day | 38 | 36 | 1.07 (0.66–1.73) | 12 | 15 | 0.78 (0.35–1.75) |
| ≥22.5 mcg/day | 26 | 16 | 1.66 (0.86–3.19) | 8 | 7 | 1.40 (0.47–4.13) |
| Recent GLP-1 RA use | 55 | 56 | 1.03 (0.69–1.53) | 23 | 24 | 0.97 (0.52–1.79) |
| Past GLP-1 RA use | 120 | 93 | 1.09 (0.82–1.46) | 47 | 41 | 0.94 (0.60–1.48) |
OR odds ratio, CI confidence interval, GLP-1 RA glucagon-like peptide-1 receptor agonist, DPP4-I dipeptidyl peptidase 4 inhibitor, NIAD non-insulin anti-diabetic-drugs, COPD chronic obstructive pulmonary disease, RAAS renin–angiotensin–aldosterone system
* Statistically significant, (P < 0.05)
aThe numbers do not add up precisely to the total number of fractures because never NIAD, past NIAD and DPP4-I use are not shown
bAdjusted for history of cancer, alcoholism, COPD, fracture, rheumatoid arthritis, hyperthyroidism, secondary osteoporosis, retinopathy, neuropathy and heart failure and use of DPP4-Is, glucocorticoids, statins, antidepressants, anxiolytics, hypnotics, antipsychotics, anti-Parkinson drugs, beta-blockers, thiazide diuretics, RAAS inhibitors, loop diuretics, antiarrhythmics
cAdjusted for (a), but not for hyperthyroidism and neuropathy
dIn exenatide equivalents