Driessen Johanna H M, de Vries Frank, van Onzenoort Hein, Harvey Nicholas C, Neef Cees, van den Bergh Joop P W, Vestergaard Peter, Henry Ronald M A
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, the Netherlands.
Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+, Maastricht, the Netherlands.
Br J Clin Pharmacol. 2017 Apr;83(4):923-926. doi: 10.1111/bcp.13167. Epub 2016 Dec 7.
The aim of the present study was to estimate the effect of incretins on fracture risk in the real-world situation by meta-analysis of the available population-based cohort data. Pubmed and Embase were searched for original articles investigating use of incretin agents, and fracture risk up to December 2015. Adjusted results were extracted and pooled by use of generic inverse variance methods, assuming a random-effects model. Neither current dipeptidyl peptidase 4-inhibitor use nor current glucagon-like peptide 1 receptor agonist use was associated with a decreased risk of fracture: pooled relative risk (pooled RR [95% confidence interval]: 1.02 [0.91-1.13] and 1.03 [0.87-1.22]), respectively. This meta-analysis demonstrated that current use of incretin agents, was not associated with decreased fracture risk. Our findings show the value of representative real-world populations, and the risks associated with suggesting benefits for medications on the basis of safety reporting in randomized controlled trials.
本研究的目的是通过对现有的基于人群的队列数据进行荟萃分析，评估在现实世界中肠促胰岛素对骨折风险的影响。检索了PubMed和Embase数据库，查找研究肠促胰岛素药物使用情况以及截至2015年12月骨折风险的原始文章。采用通用逆方差法提取并汇总校正后的结果，假定采用随机效应模型。目前使用二肽基肽酶4抑制剂或目前使用胰高血糖素样肽1受体激动剂均与骨折风险降低无关：汇总相对风险（汇总RR[95%置信区间]）分别为1.02[0.91 - 1.13]和1.03[0.87 - 1.22]）。这项荟萃分析表明，目前使用肠促胰岛素药物与骨折风险降低无关。我们的研究结果显示了具有代表性的现实世界人群的价值，以及基于随机对照试验中的安全性报告就药物益处提出建议所带来的风险。
