Most Read Articles
Jairia Dela Cruz, 14 Jan 2019
The potassium-competitive acid blocker vonoprazan demonstrates superior efficacy in the treatment of patients with erosive oesophagitis compared with the proton pump inhibitor lansoprazole, with the results of a small trial showing that the former more rapidly provides complete sustained heartburn relief during the first week of therapy.
01 Mar 2016
Bathing with 2% chlorhexidine gluconate-medicated washcloth is cost-effective for the prevention of central line-associated bloodstream infection (CLABSI), based on a systematic review and meta-analysis of four studies.
08 Jan 2019
Treatment with spironolactone has shown consistent, albeit modest, clinical effectiveness in older patients with heart failure with reduced ejection fraction (HFrEF) regardless of renal eligibility criteria used, a recent study has shown.
Rachel Soon, 12 Dec 2018

MIMS Pharmacist presents an overview of superoxide dismutase (SOD) and its role in resisting the effects of oxidative stress and aging.

Canagliflozin not associated with increased risk for fracture in T2D patients

12 Jan 2019

Use of canagliflozin, compared with a glucagon-like peptide-1 (GLP-1) agonist, does not increase the risk for fracture in middle-aged patients with type 2 diabetes and relatively low fracture risk, according to a recent study.

A total of 79,964 patients (mean age 55 years; 48 percent female; average baseline haemoglobin A1c, 8.7 percent; 27 percent were prescribed insulin) initiating use of canagliflozin were included in this study. They were matched to the same number of patients initiating use of a GLP-1 agonist.

The rate of humerus, forearm, pelvis or hip fracture that needed intervention was comparable among patients in the canagliflozin (2.2 events per 1,000 person-years) and GLP-1 agonist groups (2.3 events per 1,000 person-years; overall hazard ratio [HR], 0.98; 95 percent CI, 0.75–1.26).

There was also comparable risk for pelvic, hip, humerus, radius, ulna, carpal, metacarpal, metatarsal or ankle fracture between canagliflozin (14.5 events per 1,000 person-years) and GLP-1 agonist groups (16.1 events per 1,000 person-years; overall HR, 0.92; 0.83–1.02).

In this population-based new-user cohort study, the authors estimated risk for nonvertebral fracture among new users of canagliflozin vs GLP-1 agonist. Two US commercial healthcare databases providing data on >70 million patients were accessed from March 2013 to October 2015.

The primary outcome was a composite of humerus, forearm, pelvis, or hip fracture requiring intervention, while secondary outcomes included fractures at other sites. The authors performed a fixed-effects meta-analysis that pooled results from the databases to provide an overall HR.

The study was limited by unmeasured confounding, measurement error and low fracture rate.

“Sodium–glucose cotransporter-2 inhibitors promote glycosuria, resulting in possible effects on calcium, phosphate, and vitamin D homeostasis. Canagliflozin is associated with decreased bone mineral density and a potential increased risk for fracture,” the authors noted.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Pharmacist - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Jairia Dela Cruz, 14 Jan 2019
The potassium-competitive acid blocker vonoprazan demonstrates superior efficacy in the treatment of patients with erosive oesophagitis compared with the proton pump inhibitor lansoprazole, with the results of a small trial showing that the former more rapidly provides complete sustained heartburn relief during the first week of therapy.
01 Mar 2016
Bathing with 2% chlorhexidine gluconate-medicated washcloth is cost-effective for the prevention of central line-associated bloodstream infection (CLABSI), based on a systematic review and meta-analysis of four studies.
08 Jan 2019
Treatment with spironolactone has shown consistent, albeit modest, clinical effectiveness in older patients with heart failure with reduced ejection fraction (HFrEF) regardless of renal eligibility criteria used, a recent study has shown.
Rachel Soon, 12 Dec 2018

MIMS Pharmacist presents an overview of superoxide dismutase (SOD) and its role in resisting the effects of oxidative stress and aging.