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.