The effects of Sodium-glucose cotransporter 2 (SGLT2) inhibitors on fracture risk. A review of the literature.
Albaraa Altowijri
Abstract
Background
Diabetes mellitus is now approaching an epidemic and osteoporotic fractures had a high mortality and morbidity, Salt-glucose transporters inhibitors (SGLT-2) are relatively new class of oral hypoglycemic medications with cardio-renal protective effects, the association of SGLT-2 inhibitors with fracture risk is controversial, the current review aimed to assess the relationship of SGLT-2 inhibitors with osteoporosis and fracture risk.
Methods
An electronic literature search was carried out in the PubMed, and Google Scholar. The keywords used were SGLT2 inhibitors-canagliflozin, dapagliflozin, empagliflozin, osteoporosis, and fracture risk. Two hundred and twenty-four were found, the number stood at 21 after removing irrelevant article and duplication and applying the inclusion and exclusion criteria.
Results
There were 21 studies, six on canagliflozin, five on dapagliflozin, five on empagliflozin, and another five on drugs combinations. Six of the studies were pooled analysis, four randomized controlled trials, three reviews, two meta-analyses, one case-control study, one comparative cohort, an opinion, and one essay. No association was found between fracture risk, dapagliflozin, and empagliflozin, the results were mixed regarding canagliflozin
Conclusion
SGLT-2 inhibitors were not associated with fracture risk except canagliflozin when used among patients with cardiovascular disease or at risk and among patients with low baseline glomerular filtration rate. The observed increased fracture risk among patients taking canagliflozin may be due to fall and decreased bone mineral density due to weight loss.
Full Text:
Diabetes mellitus is now approaching an epidemic and osteoporotic fractures had a high mortality and morbidity, Salt-glucose transporters inhibitors (SGLT-2) are relatively new class of oral hypoglycemic medications with cardio-renal protective effects, the association of SGLT-2 inhibitors with fracture risk is controversial, the current review aimed to assess the relationship of SGLT-2 inhibitors with osteoporosis and fracture risk.
Methods
An electronic literature search was carried out in the PubMed, and Google Scholar. The keywords used were SGLT2 inhibitors-canagliflozin, dapagliflozin, empagliflozin, osteoporosis, and fracture risk. Two hundred and twenty-four were found, the number stood at 21 after removing irrelevant article and duplication and applying the inclusion and exclusion criteria.
Results
There were 21 studies, six on canagliflozin, five on dapagliflozin, five on empagliflozin, and another five on drugs combinations. Six of the studies were pooled analysis, four randomized controlled trials, three reviews, two meta-analyses, one case-control study, one comparative cohort, an opinion, and one essay. No association was found between fracture risk, dapagliflozin, and empagliflozin, the results were mixed regarding canagliflozin
Conclusion
SGLT-2 inhibitors were not associated with fracture risk except canagliflozin when used among patients with cardiovascular disease or at risk and among patients with low baseline glomerular filtration rate. The observed increased fracture risk among patients taking canagliflozin may be due to fall and decreased bone mineral density due to weight loss.
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