Further evidence for bone risk with glitazones
Additional evidence of a possible association between long-term use of thiazolidinediones and fractures in patients with diabetes mellitus has been published this week (Archives of Internal Medicine 2008;168:820).
The researchers say that previous studies indicate that thiazolidinediones
may have unfavourable effects on bone, resulting in reduced osteoblastic
bone formation and faster bone loss.
In a population-based study of diabetic patients, Christian Meier, University
Hospital Basel, Switzerland, and colleagues analysed data for 1,020 men
and women with a low-trauma fracture diagnosed between January 1994 and
December 2005 and for 3,728 matched controls. All patients were aged
between 30 and 89 years and attended the same general practice. Data
were derived from
the UK-based General Practice Research
database.
The researchers found that after adjusting for other risk factors, including
body mass index and use of other antidiabetes drugs, patients taking
rosiglitazone were 2.38 times more likely to sustain a fracture than
controls (95 per cent confidence interval 1.49–4.09). The association
was independent of age and sex and tended to increase with dose. A similar
trend was seen with pioglitazone.
The researchers conclude that their analysis provides additional evidence
that the use of thiazolidinediones for approximately 12 or more months
may increase the risk of osteoporotic non-vertebral fractures, particularly
of the hip and wrist, in patients with diabetes mellitus. No such effect
was seen for other antidiabetes drugs in this study population.
However,
they add that the findings need to be confirmed by
additional observational studies and by
controlled clinical trials. |
The
Pharmaceutical Journal
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