Evidence map›Paper›PMID 30083774›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018

Glucagon-like peptide-1 receptor agonists and fracture risk: a network meta-analysis of randomized clinical trials.

Y S Zhang, W Y Weng, B C Xie, Y Meng, Y H Hao, Y M Liang, Z K Zhou

Abstract readNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 6 pooled it
5.4field-weighted citation impact, top 3% 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

58 citing papers in PubMed, 6 syntheses or guidelines pooled it, 85 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Association between combined treatment with SGLT2 inhibitors and metformin for type 2 diabetes mellitus on fracture risk: a meta-analysis of randomized controlled trials.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020 · on this map
    Pooled it
  6. 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
  7. Trial
  8. Reduced postprandial bone resorption and greater rise in GLP-1 in overweight and obese individuals after an α-glucosidase inhibitor: a double-blinded randomized crossover trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Trial
  9. Article
  10. GLP-1 receptor agonists and outcomes after cervical spine fusion: a systematic review, meta-analysis, and evidence map of real-world evidence.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Review
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  18. Beyond Weight Loss: Skeletal Considerations in Obesity Treatment.Endocrinology and metabolism (Seoul, Korea) · 2026
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Y S ZhangDepartment of Pharmacy, Guangdong Medical University, No. 1, Xincheng Dadao, Songshan Lake Science and Technology Industry Park, Dongguan, 523808, China.
W Y WengDepartment of Pharmacy, Guangdong Medical University, No. 1, Xincheng Dadao, Songshan Lake Science and Technology Industry Park, Dongguan, 523808, China.
B C XieDepartment of Pharmacy, Guangdong Medical University, No. 1, Xincheng Dadao, Songshan Lake Science and Technology Industry Park, Dongguan, 523808, China.
Y MengDepartment of Pharmacy, Guangdong Medical University, No. 1, Xincheng Dadao, Songshan Lake Science and Technology Industry Park, Dongguan, 523808, China.
Y H HaoDepartment of Pharmacy, Guangdong Medical University, No. 1, Xincheng Dadao, Songshan Lake Science and Technology Industry Park, Dongguan, 523808, China.
Y M LiangDepartment of Pharmacy, Guangdong Medical University, No. 1, Xincheng Dadao, Songshan Lake Science and Technology Industry Park, Dongguan, 523808, China.
Z K ZhouDepartment of Pharmacy, Guangdong Medical University, No. 1, Xincheng Dadao, Songshan Lake Science and Technology Industry Park, Dongguan, 523808, China. zhikunzhou@126.com.ORCID http://orcid.org/0000-0001-9697-5897
Guangdong Medical College · CN

Funding

National Natural Science Foundation of China (CN) 81774344
6 · The paper itself

Abstract

Our network meta-analysis analyzed the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on fracture risk. By combining data from randomized controlled trials, we found that GLP-1 RAs were associated with a decreased bone fracture risk, and exenatide is the best option agent with regard to the risk of fracture. This study is registered with PROSPERO (CRD42018094433).

introductionData on the effects of GLP-1 RAs on fracture risk are conflicted. This study aimed to analyze the available evidence on the effects of GLP-1 RAs on fracture risk in type 2 diabetes mellitus patients.

methodsElectronic databases were searched for relevant published articles, and unpublished studies presented at ClinicalTrials.gov were searched for relevant clinical data. All analyses were performed with STATA 12.0 and R software (Version 3.4.4). We estimated the risk ratio (RR) and 95% confidence interval (CI) by combining RRs for fracture effects of included trials.

resultsThere were 54 eligible random control trials (RCTs) with 49,602 participants, including 28,353 patients treated with GLP-1 RAs. Relative to placebo, exenatide (RR, 0.17; 95% CI 0.03-0.67) was associated with lowest risk of fracture among other GLP-1 RAs. Exenatide had the highest probability to be the safest option with regard to the risk of fracture (0.07 ‰), followed by dulaglutide (1.04%), liraglutide (1.39%), albiglutide (5.61%), lixisenatide (8.07%), and semaglutide (18.72%). A statistically significant inconsistency was observed in some comparisons.

conclusionThe Bayesian network meta-analysis suggests that GLP-1 RAs were associated with a decreased bone fracture risk compared to users of placebo or other anti-hyperglycemic drugs in type 2 diabetes mellitus patients, and exenatide is the best option agent with regard to the risk of fracture.

Indexed as

Glucagon-Like Peptide-1 Receptor AgonistsBayes TheoremDiabetes Mellitus, Type 2ExenatideHumansHypoglycemic AgentsOsteoporotic FracturesRandomized Controlled Trials as TopicExenatideGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsFractureGlucagon-like peptide-1 receptor agonistsNetwork meta-analysisType 2 diabetes mellitus

Identifiers

PMID30083774
OpenAlexW2885062261

What OpenQuestion holds

Textmetadata
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.