Impact of sodium-glucose cotransporter-2 inhibitors on the risk of hip fracture in older patients in Japan using a nationwide administrative claims database: A matched case control study
Impact of sodium-glucose cotransporter-2 inhibitors on the risk of hip fracture in older patients in Japan using a nationwide administrative claims database: A matched case control study
复制标题
使用全国行政索赔数据库研究钠-葡萄糖协同转运蛋白 2 抑制剂对日本老年患者髋部骨折风险的影响：一项匹配的病例对照研究
DOI：
10.1111/ggi.14591
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发表时间：
2023
影响因子：
3.3
通讯作者：
Hiroyuki Daida
中科院分区：
文献类型：
--
作者：
Tomoyuki Saito;Shuko Nojiri;Takatoshi Kasai;Yoshimune Hiratsuka;Muneaki Ishijima;Hiroyuki Daida
一些临床试验表明，钠-葡萄糖协同转运蛋白-2（SGLT-2）抑制剂与骨折风险相关。然而，这一概念仍有争议。本研究旨在评价使用SGLT 2抑制剂后的髋部骨折风险，同时控制可能影响骨折风险的因素。此外，评估了与SGLT 2抑制剂组分及其与其他降糖药物合并使用相关的髋部骨折风险。MethodsUsing large scale真实的world data，this case-control study investigated postoperative patients between January 2018 and December 2020.患者年龄为65-89岁，至少接受过两次SGLT 2抑制剂处方。根据性别、年龄（±3岁）、医院规模分类和合并降糖药数量，通过1：3匹配确定髋部骨折患者（病例）和无髋部骨折患者（对照）。暴露于SGLT 2抑制剂的情况下，对照组进行了比较，使用多变量条件Logistic regression.ResultsAfter matching，396例和1081对照组被确定。接受SGLT 2抑制剂治疗的患者的校正比值比为0.83（95%置信区间：0.55-1.26），表明髋部骨折风险未增加。此外，没有观察到风险增加与SGLT 2抑制剂的组成部分或与其他抗糖尿病agents.ConclusionOur研究表明，SGLT 2抑制剂不增加老年患者髋部骨折。然而，由于SGLT 2抑制剂组分及其与其他降糖药物合并使用的风险评估是基于有限数量的患者，因此谨慎解释结果非常重要。Geriatr Gerontol Int 2023; 23：418-425。
AimSome clinical trials have shown that sodium‐glucose cotransporter‐2 (SGLT2) inhibitors are associated with fracture risk. However, this notion remains controversial. This study aimed to evaluate hip fracture risk after the use of SGLT2 inhibitors while controlling for factors that may affect fracture risk. Furthermore, hip fracture risk is evaluated in relation to the SGLT2 inhibitors component and its concomitant use with other antidiabetic agents.MethodsUsing large‐scale real‐world data, this case–control study investigated hospitalized patients between January 2018 and December 2020. Patients were aged 65–89 years and had been prescribed with SGLT2 inhibitors at least twice. Patients with hip fracture (cases) and those without (controls) were identified via 1:3 matching according to sex, age (±3 years), hospital size classification, and number of concomitant antidiabetic agents. Exposure to SGLT2 inhibitors of the cases and controls was compared with the use of multivariate conditional logistic regression.ResultsAfter matching, 396 cases and 1081 controls were identified. The adjusted odds ratio for patients receiving treatment with SGLT2 inhibitors was 0.83 (95% confidence interval: 0.55–1.26), indicating no increase in hip fracture risk. Additionally, no increased risk was observed with respect to SGLT2 inhibitors by component or concomitant use with other antidiabetic agents.ConclusionOur study showed that SGLT2 inhibitors do not increase hip fractures in older patients. However, because the risk assessment of SGLT2 inhibitors by component and their concomitant use with other antidiabetic agents is based on a limited number of patients, it is important to interpret the results with caution.Geriatr Gerontol Int 2023; 23: 418–425.