Bone fracture risk is not associated with the use of glucagon-like peptide-1 receptor agonists: a population-based cohort analysis
Open accessAbstract
Glucagon-like Peptide-1 receptor agonists (GLP1-ra) are a relatively new class of anti-hyperglycemic drugs which may positively affect bone metabolism and thereby decrease (osteoporotic) bone fracture risk. Data on the effect of GLP1-ra on fracture risk are scarce and limited to clinical trial data only. The aim of this study was to investigate, in a population-based cohort, the association between the use of GLP1-ra and bone fracture risk. We conducted a population-based cohort study, with the use of data from the Clinical Practice Research Datalink (CPRD) database (2007-2012). The study population (N = 216,816) consisted of all individuals with type 2 diabetes patients with at least one prescription for a non-insulin anti-diabetic drug and were over 18 years of age. Cox proportional hazards models were used to estimate the hazard ratio of fracture in GLP1-ra users versus never-GLP1-ra users. Time-dependent adjustments were made for age, sex, lifestyle, comorbidity and the use of other drugs. There was no decreased risk of fracture with current use of GLP1-ra compared to never-GLP1-ra use (adjusted HR 0.99, 95 % CI 0.82-1.19). Osteoporotic fracture risk was also not decreased by current GLP1-ra use (adjusted HR 0.97; 95 % CI 0.72-1.32). In addition, stratification according to cumulative dose did not show a decreased bone fracture risk with increasing cumulative GLP1-ra dose. We showed in a population-based cohort study that GLP1-ra use is not associated with a decreased bone fracture risk compared to users of other anti-hyperglycemic drugs. Future research is needed to elucidate the potential working mechanisms of GLP1-ra on bone.
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Studies of type 2 diabetes patients have indicated that GLP-1 receptor agonists have no effect on bone metabolism or fracture risk.
“Conversely, studies of type 2 diabetes patients have indicated that GLP-1 receptor agonists have no effect on bone metabolism or fracture risk (15, 16).”
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References 34 · Cited by 79
- Authors
- Driessen, J. H. M., Henry, R. M. A., van Onzenoort, H. A. W., Lalmohamed, A., Burden, A. M., Prieto-Alhambra, D., Neef, C., Leufkens, H. G. M., & de Vries, F.
- Affiliations
- Utrecht University (NL)
- Maastricht University Medical Centre (NL)
- University Medical Center Utrecht (NL)
- ORCID
- Venue
- Calcified Tissue International
- Published
- 2015-04-17
- Volume
- 97
- Issue
- 2
- Pages
- 104-112
- ISSN
- 0171-967X (ISSN-L)
- 1432-0827
- PMC
- PMC4491344
- OpenAlex
- W2147618898
- Cited by
- 79
- References
- 34
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 6 · 2023: 1 · 2022: 4 · 2021: 2 · 2020: 4 · 2019: 11 · 2018: 12 · 2017: 13 · 2016: 4 · 2015: 6
- FWCI
- 10.14
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Calcified Tissue International (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- GLP-1 receptor agonists, bone fracture risk, osteoporotic fractures, type 2 diabetes, anti-hyperglycemic drugs, bone metabolism, cumulative dose, drug safety
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Adolescent, Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Risk Factors, Cohort Studies, Incidence, Proportional Hazards Models, Fractures, Bone, Young Adult
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