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New study challenges previous link between diabetes medication and fractures

Washington: Sodium-glucose transporter-2 (SGLT2) inhibitors, which reduce renal glucose reabsorption, may help control blood sugar and protect kidney health in patients with diabetic renal failure; however, several large clinical trials have linked these drugs to a higher risk of bone fracture.

In a recent study published in the journal CJASN, an SGLT2 inhibitor was not associated with a higher risk of fracture than another diabetes drug, regardless of the patient's kidney function. The study, which was conducted by Andrea Cowan, MD (London Health Sciences Centre) and her colleagues, compared fracture rates in adults aged 66 years or older who were prescribed SGLT-2 inhibitors vs. those prescribed a different diabetes medication--called dipeptidyl peptidase (DPP-4) inhibitors--that have not been linked to fractures. The analysis included 38,994 new users of an SGLT2 inhibitor and 37,449 new users of a DPP-4 inhibitor in Ontario, Canada. The study excluded individuals with severely decreased kidney function.

Overall, there were 342 fractures at 180 days and 689 fractures at 365 days. There was no difference in fracture risk between individuals prescribed an SGLT-2 inhibitor and those prescribed a DPP-4 inhibitor--both in the whole group and in those with decreased kidney function, who already face an elevated risk of experiencing fractures.
"This study re-assures patients and doctors that SGLT-2 inhibitors are not associated with an increased risk of fracture in patients with chronic kidney disease," said Dr. Cowan.
Accompanying editorial notes that the study "adds to the growing body of evidence related to the safety of SGLT2 inhibitors, however, it should encourage continued basic and clinical studies to determine with more certainty their potential risk of fractures, especially in individuals with more advanced chronic kidney disease."

Velcheti, who also serves as director of Perlmutter's thoracic medical oncology program, cautions that further results from the ongoing study would have to demonstrate similar benefits before nemvaleukin alfa treatment could become a "standard of care," or go-to therapy, for patients with advanced cancers. (ANI)

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