Pioglitazone and Risk for Bone Fracture: Safety Data from a Randomized Clinical Trial (original) (raw)

“…Bone fractures are another potential side effect of pioglitazone treatment. These are mainly low energy fractures (ie, associated with a fall) of distal long bones of the upper and lower limbs, a finding recently confirmed in the IRIS population . No signal for increased risk of bone fractures has been reported with the use of DPP4i; thus, no additional risk is expected when used in combination with pioglitazone.…”

Section: Safety Considerations: Balance Between Risk and Benefitmentioning

“…Bone fractures are another potential side effect of pioglitazone treatment. These are mainly low energy fractures (ie, associated with a fall) of distal long bones of the upper and lower limbs, a finding recently confirmed in the IRIS population . No signal for increased risk of bone fractures has been reported with the use of DPP4i; thus, no additional risk is expected when used in combination with pioglitazone.…”

Section: Safety Considerations: Balance Between Risk and Benefitmentioning

“…This concern derives mostly from the fact that thiazolidinediones (TZDs) are associated with increased fracture rates. This detrimental bone effect has been primarily observed for rosiglitazone, but has also been reported for pioglitazones, although a recent systemic review and meta‐analysis did not observe any increased risk of fracture in diabetes patients taking pioglitazone …”

Section: Effects Of Hypoglycemic Agents and Bariatric Surgery On Bonementioning

“…Which drug should be used? Are GLP‐1 analogues safe and effective, since endogenous GLP‐1 already increases after surgery? Do SGLT2 inhibitors increase the rates of diabetes ketoacidosis (DKA) after bariatric surgery since DKA has been described after both surgeries and use of SGLT2 inhibitors? Should we use sulphonylureas and/or insulin, which could decrease the amount of weight loss? How about the risk of fracture during treatment with pioglitazone as well as weight gain? We will probably not have definitive answers for all these questions in the short or mid term, but the increased use of bariatric surgery in T2DM should prompt the publication of management guidelines for these patients.…”

Section: Combining All Data: Why Should We Exert Caution In Recommendmentioning

“…144 How about the risk of fracture during treatment with pioglitazone as well as weight gain? 144,145 We will probably not have definitive answers for all these questions in the short or mid term, but the increased use of bariatric surgery in T2DM should prompt the publication of management guidelines for these patients.…”

Section: Combining All Data: Why Should We Exert Caution In Recommementioning