Back to Search
Start Over
Sitagliptin and risk of fractures in type 2 diabetes: Results from the TECOS trial
- Source :
- Diabetes, Obesity and Metabolism. 19:78-86
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- Aim To examine fracture incidence among participants in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS). Research design and methods We used data from 14 671 participants in the TECOS study who were randomized double-blind to sitagliptin (n = 7332) or placebo (n = 7339). Cumulative fracture incidence rates were calculated and their association with study treatment assignment was examined using multivariable Cox proportional hazards regression. Results The baseline mean (standard deviation) participant age was 65.5 (8.0) years, diabetes duration was 11.6 (8.1) years and glycated haemoglobin level was 7.2 (0.5)% [55.2 (5.5) mmol/mol], and 29.3% of participants were women and 32.1% were non-white. During 43 222 person-years’ follow-up, 375 (2.6%; 8.7 per 1000 person-years) had a fracture; 146 were major osteoporotic fractures (hip, n = 34; upper extremity, n = 81; and clinical spine, n = 31). Adjusted analyses showed fracture risk increased independently with older age (P < .001), female sex (P < .001), white race (P < .001), lower diastolic blood pressure (P < .001) and diabetic neuropathy (P = .003). Sitagliptin, compared with placebo, was not associated with a higher fracture risk [189 vs 186 incident fractures: unadjusted hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.82 to 1.23, P = .944; adjusted HR 1.03, P = .745], major osteoporotic fractures (P = .673) or hip fractures (P = .761). Insulin therapy was associated with a higher fracture risk (HR 1.40, 95% CI 1.02-1.91; P = .035), and metformin with a lower risk (HR 0.76, 95% CI 0.59-0.98; P = .035). Conclusion Fractures were common among people with diabetes in the TECOS study, but were not related to sitagliptin therapy. Insulin and metformin treatment were associated with higher and lower fracture risks, respectively.
- Subjects :
- medicine.medical_specialty
business.industry
Endocrinology, Diabetes and Metabolism
Hazard ratio
030209 endocrinology & metabolism
Type 2 diabetes
030204 cardiovascular system & hematology
medicine.disease
Placebo
Lower risk
Confidence interval
Surgery
Metformin
03 medical and health sciences
0302 clinical medicine
Endocrinology
Diabetes mellitus
Internal medicine
Sitagliptin
Internal Medicine
medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 14628902
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Diabetes, Obesity and Metabolism
- Accession number :
- edsair.doi...........26952b54efc6270cbac51747c8a88ba9