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Prescribing Advice for GPs

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Additional glitazone fracture data

The Archives of Internal Medicine has published the results of an analysis that examined the association between the use of glitazones or other oral anti-diabetic drugs and the risk of fracture.

The analysis queried the UK General Practice Research Database for patients aged 30 to 89 years who had a fracture between January 1994 and December 2005. Control patients were matched for age, gender and general practice attended.

The study identified 1,020 case patients with a low trauma fracture and 3,728 controls. After correction for several factors including age, body mass index and co-morbidities users of glitazones were at statistically higher risk of fractures; odds ratio 2.43 (95% confidence interval [CI], 1.49-3.95). The risk also appeared to be dose related. There were no detectable differences associated with the other oral anti-diabetic drugs.

The authors conclude that, "this analysis provides further evidence of a possible association between long-term use of thiazolidinediones [glitazones] and fractures".

Action: Clinicians should reserve glitazone use for patients who are contraindicated to or cannot tolerate metformin and/or a sulphonylurea.

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