PMID- 27321347
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20221207
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 116
DP  - 2016 Jun
TI  - DPP-4 inhibitor therapy and bone fractures in people with Type 2 diabetes - A 
      systematic review and meta-analysis.
PG  - 288-98
LID - S0168-8227(16)30093-6 [pii]
LID - 10.1016/j.diabres.2016.04.029 [doi]
AB  - AIM: Fracture risk is higher in older adults with Type 2 diabetes mellitus 
      (T2DM). Oral glucose-lowering medications have different effects on bone 
      metabolism. The purpose of this study is to appraise the evidence from literature 
      and determine the effect of dipeptidyl peptidase-4 (DPP-4) inhibitor on the risk 
      of developing bone fractures. METHODS: Using Boolean search terms, the search 
      strategy combined synonyms of 'fracture' and 'DPP-4 inhibitor'. Comprehensive 
      electronic databases which include EMBASE, MEDLINE, the EMA and the WHO ICTRP 
      databases were searched for randomised controlled trial (RCT) studies which 
      compared a DPP-4 inhibitor with an active comparator or placebo amongst patients 
      with T2DM. Meta-analysis was performed to compare DPP-4 inhibitor with either an 
      active comparator or a placebo. The outcome measure was the presence or absence 
      of fracture. RESULTS: The search yielded 5061 records relating to fractures and 
      DPP-4 inhibitor, from which 51 eligible RCTs were selected for meta-analysis 
      (N=36,402). Thirty-seven (37) studies compared DPP-4 inhibitor with placebo 
      (n=23,974), while fourteen (14) studies (n=12,428) compared DPP-4 inhibitor with 
      an active comparator. The mean age of patients was 57.5+/-5.4years, the average 
      glycated haemoglobin (HbA1c) was 8.2%, while the average BMI was 30+/-2kg/m(2). 
      Overall, there was no significant association of fracture events with the use of 
      DPP-4 inhibitor when compared with placebo (OR; 0.82, 95% CI 0.57-1.16, P=0.9) or 
      when DPP-4 inhibitor was compared against an active comparator (OR; 1.59, 95% CI 
      0.91-2.80, P=0.9). CONCLUSION: This study offers a larger, up-to-date review of 
      the subject. The meta-analysis showed that there was no significant association 
      between DPP-4 inhibitor use and the incidence of fractures.
CI  - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved.
FAU - Mamza, Jil
AU  - Mamza J
AD  - Division of Medical Sciences & Graduate Entry Medicine, University of Nottingham, 
      UK.
FAU - Marlin, Carol
AU  - Marlin C
AD  - Division of Medical Sciences & Graduate Entry Medicine, University of Nottingham, 
      UK.
FAU - Wang, Cai
AU  - Wang C
AD  - Division of Medical Sciences & Graduate Entry Medicine, University of Nottingham, 
      UK.
FAU - Chokkalingam, Kamal
AU  - Chokkalingam K
AD  - Nottingham University Hospitals NHS Trust, Nottingham, UK.
FAU - Idris, Iskandar
AU  - Idris I
AD  - Division of Medical Sciences & Graduate Entry Medicine, University of Nottingham, 
      UK. Electronic address: Iskandar.Idris@nottingham.ac.uk.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20160430
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Dipeptidyl-Peptidase IV Inhibitors/*adverse effects/therapeutic use
MH  - Fractures, Bone/*chemically induced
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemic Agents/*adverse effects/therapeutic use
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - Dipeptidyl peptidase-4 inhibitor
OT  - Fracture
OT  - Meta-analysis
EDAT- 2016/06/21 06:00
MHDA- 2016/12/15 06:00
CRDT- 2016/06/21 06:00
PHST- 2016/02/08 00:00 [received]
PHST- 2016/03/29 00:00 [revised]
PHST- 2016/04/16 00:00 [accepted]
PHST- 2016/06/21 06:00 [entrez]
PHST- 2016/06/21 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
AID - S0168-8227(16)30093-6 [pii]
AID - 10.1016/j.diabres.2016.04.029 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2016 Jun;116:288-98. doi: 10.1016/j.diabres.2016.04.029. 
      Epub 2016 Apr 30.