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Sulfonylurea Use and Risk of Hip Fractures Among Elderly Men and Women with Type 2 Diabetes

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Abstract

Background

Both increased age and type 2 diabetes mellitus are risk factors for developing bone fractures. While recent data in the elderly suggest a link between hypoglycemia and fall-related fractures, the association between sulfonylureas, commonly used hypoglycemic agents, and fracture risk has not been well investigated.

Methods

We used patient data from a large commercial health insurer from 2002–2005. Individuals aged ≥65 years receiving oral sulfonylurea treatment (n = 13,195) were matched 1:1 to non-users based on propensity for sulfonylurea use. Multivariable conditional logistic regression was used to estimate adjusted odds ratios (aOR) and 95 % confidence intervals (CIs).

Results

During an average 4 years of follow-up, sulfonylurea users experienced 226 incident hip fractures (1.7 %) and non-users experienced 157 (1.2 %). Sulfonylurea use was associated with increased risk of developing hip fracture (aOR 1.46, 95 % CI 1.17–1.82), and this association was apparent for men (120 cases; aOR 1.83, 95 % CI 1.25–2.66) and women (263 cases; aOR 1.32, 95 % CI 1.03–1.69). Patients with documented hypoglycemia in the follow-up period had increased odds of hip fracture relative to those without such diagnosis (aOR 2.42, 95 % CI 1.35–4.34).

Conclusion

Sulfonylureas are associated with increased risk of hip fracture in elderly men and women with type 2 diabetes.

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Acknowledgments

This work was funded by Merck & Co.

Conflicts of interest

Dr. Rajpathak, Ms. Fu, Dr. Brodovicz and Dr. Engel are employees of Merck & Co. Dr. Lapane has no conflicts of interest to declare.

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Authors and Affiliations

  1. Center for Observational and Real-World Evidence, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, NJ, USA

    Swapnil N. Rajpathak, Chunmay Fu & Kimberly G. Brodovicz

  2. Merck Research Laboratories, Merck & Co., Inc., Kenilworth, NJ, USA

    Samuel S. Engel

  3. University of Massachusetts Medical School, Worcester, MA, USA

    Kate Lapane

Authors
  1. Swapnil N. Rajpathak
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  2. Chunmay Fu
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  3. Kimberly G. Brodovicz
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  4. Samuel S. Engel
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  5. Kate Lapane
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Corresponding author

Correspondence to Swapnil N. Rajpathak.

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Rajpathak, S.N., Fu, C., Brodovicz, K.G. et al. Sulfonylurea Use and Risk of Hip Fractures Among Elderly Men and Women with Type 2 Diabetes. Drugs Aging 32, 321–327 (2015). https://doi.org/10.1007/s40266-015-0254-0

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