Evidence map›Paper›PMID 25894068›Full record

ArticleCalcified tissue international2015

Bone fracture risk is not associated with the use of glucagon-like peptide-1 receptor agonists: a population-based cohort analysis.

Johanna H M Driessen, Ronald M A Henry, Hein A W van Onzenoort, Arief Lalmohamed, Andrea M Burden, Daniel Prieto-Alhambra, Cees Neef, Hubert G M Leufkens, Frank de Vries

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Calcified tissue international, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 8 pooled it
7.8field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 8 syntheses or guidelines pooled it, 73 citations in OpenAlex.

  1. Pooled it
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  7. 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 · 2019
    Pooled it
  8. Pooled it
  9. Trial
  10. Article
  11. GLP-1 Agonists in Orthopedic Surgery: A Narrative Review of Bone Health and Surgical Implications.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2026
    Review
  12. Review
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  14. The Effects of GLP-1 Agonists on Musculoskeletal Health and Orthopedic Care.Current reviews in musculoskeletal medicine · 2025
    Review
  15. Article
  16. Review
  17. Article
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  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 2 countries.

Johanna H M DriessenDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
Ronald M A Henry
Hein A W van Onzenoort
Arief Lalmohamed
Andrea M Burden
Daniel Prieto-Alhambra
Cees Neef
Hubert G M Leufkens
Frank de Vries
Utrecht University · NLMaastricht University · NLMaastricht University Medical Centre · NLMRC Lifecourse Epidemiology Unit · GBRadboud University Nijmegen · NLSouthampton General Hospital · GBUniversity Medical Center Utrecht · NL

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

Glucagon-like Peptide-1 receptor agonists (GLP1-ra) are a relatively new class of anti-hyperglycemic drugs which may positively affect bone metabolism and thereby decrease (osteoporotic) bone fracture risk. Data on the effect of GLP1-ra on fracture risk are scarce and limited to clinical trial data only. The aim of this study was to investigate, in a population-based cohort, the association between the use of GLP1-ra and bone fracture risk. We conducted a population-based cohort study, with the use of data from the Clinical Practice Research Datalink (CPRD) database (2007-2012). The study population (N = 216,816) consisted of all individuals with type 2 diabetes patients with at least one prescription for a non-insulin anti-diabetic drug and were over 18 years of age. Cox proportional hazards models were used to estimate the hazard ratio of fracture in GLP1-ra users versus never-GLP1-ra users. Time-dependent adjustments were made for age, sex, lifestyle, comorbidity and the use of other drugs. There was no decreased risk of fracture with current use of GLP1-ra compared to never-GLP1-ra use (adjusted HR 0.99, 95 % CI 0.82-1.19). Osteoporotic fracture risk was also not decreased by current GLP1-ra use (adjusted HR 0.97; 95 % CI 0.72-1.32). In addition, stratification according to cumulative dose did not show a decreased bone fracture risk with increasing cumulative GLP1-ra dose. We showed in a population-based cohort study that GLP1-ra use is not associated with a decreased bone fracture risk compared to users of other anti-hyperglycemic drugs. Future research is needed to elucidate the potential working mechanisms of GLP1-ra on bone.

Indexed as

AdolescentAdultAgedAged, 80 and overCohort StudiesDiabetes Mellitus, Type 2FemaleFractures, BoneGlucagon-Like Peptide-1 Receptor AgonistsHumansHypoglycemic AgentsIncidenceMaleMiddle AgedProportional Hazards ModelsRisk FactorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic Agents

Identifiers

PMID25894068
PMCPMC4491344
OpenAlexW2147618898

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.