Thiazolidinedione Increases the Risk of Fracture

Investigators: Ronald Aubert, PhD¹,Vivian Herrera, DDS¹, Lorraine Tully, RHIT¹, Zhuliang Tao, MPH¹, Glen Stettin, MD¹, Inderpal Bhandari, PhD¹, Steve Haffner, MD,² Merri Pendergrass, MD, PhD¹.

Presented on June 6, 2009, at the American Diabetes Association’s 69th Scientific Sessions.

Study in Brief:
- This study examined the association between thiazolidinedione (TZD) use and the risk of fracture in patients with Type 2 diabetes.

- The sample identified 144,399 patients with Type 2 diabetes whose diabetes medications included a TZD, a sulfonylurea, and/or metformin.

- The patient sample was divided into two groups. One cohort was made up of 69,047 patients who were taking a TZD (either rosiglitazone or pioglitazone), and the other included 75,352 patients who were not prescribed a TZD. The average age for both groups was 56.

- After adjusting for age, COPD, asthma, osteoporosis, stroke, and prior fracture, TZD users had a 43 percent higher rate of fracture than those not taking a TZD. The fracture risk was the same whether the subject was taking rosiglitazone or pioglitazone.

- When analyzed by gender, women on a TZD were 55 percent more likely to have a fracture than females not using the drug, and men on a TZD had a 26 percent higher likelihood of a fracture than men in the control group.

- Fracture rates were also measured among a subset of subjects who filled a TZD prescription for the first time during the study period (n = 11,738) as compared with 13,563 patients who filled a diabetes medication other than a TZD for the first time.

- While women who were new to TZD treatment were at a 40% higher risk for a fracture than females new to a control medication, men newly started on TZD treatment showed no difference than those not taking a TZD during the study period.

¹Medco Health Solutions, Inc., Franklin Lakes, NJ
²University of Texas Health Sciences Center, San Antonio, TX