Rosiglitazone and pioglitazone increase fracture risk in women and men with type 2 diabetes

被引:112
作者
Aubert, R. E. [1 ]
Herrera, V. [1 ]
Chen, W. [1 ]
Haffner, S. M.
Pendergrass, M. [1 ,2 ]
机构
[1] Medco Hlth Solut Inc, Franklin Lakes, NJ USA
[2] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA
关键词
diabetes; fracture; pioglitazone; rosiglitazone; thiazolidinedione; PROGRESSION TRIAL ADOPT; CHRONIC DISEASE SCORE; THIAZOLIDINEDIONE USE; ADULTS; THERAPY; GLUCOSE; HEALTH;
D O I
10.1111/j.1463-1326.2010.01225.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Materials and Methods: A research database of integrated pharmacy and medical claims was analysed using Cox models adjusted for age, gender, chronic obstructive pulmonary disease, asthma, osteoporosis, stroke, prior fracture and chronic disease score. Patients were followed for 540 days. Results: There was a 39% higher [adjusted hazard ratio (HR), 1.39; 95% confidence interval (CI), 1.32-1.46] incidence of fractures in men and women exposed to a TZD (n = 69047; age = 56 +/- 5 years; 59% men; 48% rosiglitazone) compared with that in control patients (n = 75352; age = 56 +/- 5 years; 51% men). Men treated with a TZD had a higher likelihood of fracture than control patients (adjusted HR rosiglitazone, 1.47; 95% CI, 1.38-1.56; adjusted HR pioglitazone, 1.43; 95% CI, 1.34-1.52). The HRs associated with pioglitazone (adjusted HR, 1.43; 95% CI, 1.34-1.52) and rosiglitazone (adjusted HR, 1.47; 95% CI, 1.38-1.56) were almost identical. TZD use was associated with a higher fracture risk in women aged above and below 50 years and in men aged above 50 years. Conclusions: Our findings add support to the growing literature that TZD treatment is associated with an increased risk of fractures in both men and women, that effects of rosiglitazone and pioglitazone are similar and that fracture risk is increased even in younger women.
引用
收藏
页码:716 / 721
页数:6
相关论文
共 29 条
[1]  
Ahmad SR, 2008, NEW ENGL J MED, V358, P1970
[2]   Risk of Fractures with Glitazones A Critical Review of the Evidence to Date [J].
Bodmer, Michael ;
Meier, Christian ;
Kraenzlin, Marius E. ;
Meier, Christoph R. .
DRUG SAFETY, 2009, 32 (07) :539-547
[3]   Risk of fracture in women with type 2 diabetes: The Women's Health Initiative Observational Study [J].
Bonds, Denise E. ;
Larson, Joseph C. ;
Schwartz, Ann V. ;
Strotmeyer, Elsa S. ;
Robbins, John ;
Rodriguez, Beatriz L. ;
Johnson, Karen C. ;
Margolis, Karen L. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2006, 91 (09) :3404-3410
[4]   The influence of glucose-lowering therapies on cancer risk in type 2 diabetes [J].
Currie, C. J. ;
Poole, C. D. ;
Gale, E. A. M. .
DIABETOLOGIA, 2009, 52 (09) :1766-1777
[5]   Thiazolidinediones and Fractures in Men and Women [J].
Dormuth, Colin R. ;
Carney, Greg ;
Carleton, Bruce ;
Bassett, Ken ;
Wright, Jarnes M. .
ARCHIVES OF INTERNAL MEDICINE, 2009, 169 (15) :1395-1402
[6]   The Risk of Fractures Associated with Thiazolidinediones: A Self-controlled Case-Series Study [J].
Douglas, Ian J. ;
Evans, Stephen J. ;
Pocock, Stuart ;
Smeeth, Liam .
PLOS MEDICINE, 2009, 6 (09)
[7]   Skeletal consequences of thiazolidinedione therapy [J].
Grey, A. .
OSTEOPOROSIS INTERNATIONAL, 2008, 19 (02) :129-137
[8]  
HABIB ZA, 2002, J CLIN ENDOCR METAB, V95, P592
[9]   Rosiglitazone evaluated for cardiovascular outcomes in oral agent combination therapy for type 2 diabetes (RECORD): a multicentre, randomised, open-label trial [J].
Home, Philip D. ;
Pocock, Stuart J. ;
Beck-Nielsen, Henning ;
Curtis, Paula S. ;
Gomis, Ramon ;
Hanefeld, Markolf ;
Jones, Nigel P. ;
Komajda, Michel ;
McMurray, John J. V. .
LANCET, 2009, 373 (9681) :2125-2135
[10]  
Jones SG, 2009, AM J MANAG CARE, V15, P491