SynthesisEndocrine2015
Risk of bone fractures associated with glucagon-like peptide-1 receptor agonists' treatment: a meta-analysis of randomized controlled trials.
Synthesis in Endocrine, 2015. The graph read 2 numbers from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. It also reports 2 associations that do not count as treatment evidence, such as OR 0.38 (0.17 to 0.87) for adverse events & safety. It reports registered trial NCT02473809. Cited by 98 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
Read, but not usablea number the graph found but could not read as for or against
Liraglutide treatment was associated with a significant reduced risk of incident bone fractures (MH-OR=0.38, 95% CI 0.17-0.87); however, exenatide treatment was associated with an elevated risk of incident bone fractures (MH-OR=2.09, 95% CI 1.03-4.21).
Liraglutide treatment was associated with a significant reduced risk of incident bone fractures (MH-OR=0.38, 95% CI 0.17-0.87); however, exenatide treatment was associated with an elevated risk of incident bone fractures (MH-OR=2.09, 95% CI 1.03-4.21).
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Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
GLP-1 receptor agonists×adverse events & safety
No readable resultOpen on the map →What to test next →40 readable studies in this cell: 45 favour the treatment, 14 find no difference, 2 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Liraglutide on Bone Turnover, Bone Mass and Bone Cell Function
Who cites it
98 citing papers in PubMed, 8 syntheses or guidelines pooled it, 193 citations in OpenAlex.
- GLP-1 Receptor Agonists and Noncardiometabolic Outcomes: An Umbrella Review of Meta-Analyses.JAMA network open · 2026Pooled it
- Liraglutide, a glucagon-like peptide-1 receptor agonist, inhibits bone loss in an animal model of osteoporosis with or without diabetes.Frontiers in endocrinology · 2024Pooled it
- Risk of bone fracture by using dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, or sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes mellitus: a network meta-analysis of population-based cohort studies.Frontiers in endocrinology · 2024Pooled it
- [Diagnosis and management of patients with diabetes and co-existing osteoporosis (Update 2023) : Common guideline of the Austrian Society for Bone and Mineral Research and the Austrian Diabetes Society].Wiener klinische Wochenschrift · 2023Guideline
- The Impact of GLP1 Agonists on Bone Metabolism: A Systematic Review.Medicina (Kaunas, Lithuania) · 2022Pooled it
- Pooled it
- Risk of fracture with dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, or sodium-glucose cotransporter-2 inhibitors in real-world use: systematic review and meta-analysis of observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Pooled it
- The use of incretins and fractures - a meta-analysis on population-based real life data.British journal of clinical pharmacology · 2017Pooled it
- Bone Health After Exercise Alone, GLP-1 Receptor Agonist Treatment, or Combination Treatment: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2024 · on this mapTrial
- Muscle and Bone Implications of GLP-1 Receptor Agonists and Fragility Fractures in Older Adults With Diabetes.Journal of cachexia, sarcopenia and muscle · 2026Article
- Unconventional Applications of Semaglutide and Tirzepatide: From Oncology to Human Reproduction.Biomedicines · 2026Review
- Effects of the glucagon-like peptide-1 receptor agonist PEG-Loxe on diabetic osteoporosis: A mechanistic study.Molecular metabolism · 2026Article
- GLP-1 and GIP: Magic bullet for musculoskeletal diseases?Journal of advanced research · 2026Review
- Do GLP-1 agonists affect perioperative risk in spine surgery? A systematic review and meta-analysis.North American Spine Society journal · 2026Review
- Brazilian guidelines for the management of osteoporosis in diabetes mellitus.Diabetology & metabolic syndrome · 2025Review
- Obesity and Exercise: New Insights and Perspectives.Endocrine reviews · 2025Review
- Review
- Tirzepatide, a dual GLP-1 and GIP receptor agonist, promotes bone loss in obese mice via gut microbial-related metabolites.Journal of orthopaedic translation · 2025Article
- Exenatide, a glucagon-like peptide-1 receptor agonist, may negatively impact bone healing in rats: histopathological, biochemical, and in silico findings.Journal of orthopaedic surgery and research · 2025Article
- The Effects of GLP-1 Agonists on Musculoskeletal Health and Orthopedic Care.Current reviews in musculoskeletal medicine · 2025Review
38 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
Traditional anti-diabetic drugs may have negative or positive effects on risk of bone fractures. Yet the relationship between the new class glucagon-like peptide-1 receptor agonists (GLP-1 RA) and risk of bone fractures has not been established. We performed a meta-analysis including randomized controlled trials (RCT) to study the risk of bone fractures associated with liraglutide or exenatide, compared to placebo or other active drugs. We searched MEDLINE, EMBASE, and clinical trial registration websites for published or unpublished RCTs comparing the effects of liraglutide or exenatide with comparators. Only studies with disclosed bone fracture data were included. Separate pooled analysis was performed for liraglutide or exenatide, respectively, by calculating Mantel-Haenszel odds ratio (MH-OR). 16 RCTs were identified including a total of 11,206 patients. Liraglutide treatment was associated with a significant reduced risk of incident bone fractures (MH-OR=0.38, 95% CI 0.17-0.87); however, exenatide treatment was associated with an elevated risk of incident bone fractures (MH-OR=2.09, 95% CI 1.03-4.21). Publication bias and heterogeneity between studies were not observed. Our study demonstrated a divergent risk of bone fractures associated with different GLP-1 RA treatments. The current findings need to be confirmed by future well-designed prospective or RCT studies.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.