{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:43:05Z","timestamp":1792600985128,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetes mellitus\u2014a chronic metabolic disorder associated with an increased risk of muscle atrophy\u2014can significantly impact patients' quality of life and overall health outcomes. While antidiabetic medications are crucial for managing blood glucose levels, some have been linked to muscle\u2010related adverse events, potentially exacerbating the already elevated risk of muscle deterioration in diabetic patients. However, a comprehensive analysis of muscle atrophy\u2010related adverse events across different classes of antidiabetic drugs has been lacking. Therefore, this study investigates the profile of muscle atrophy\u2010related adverse events across major antidiabetic drug classes using the World Health Organization's (WHO's) Individual Case Safety Reports database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A pharmacovigilance analysis was conducted using data from VigiBase, the WHO's global reporting database, from 1968 to September 2025. The study examined adverse event signals related to muscle atrophy, sarcopenia, muscular weakness and motor function decline for nine classes of antidiabetic medications. Reporting odds ratios (RORs) were calculated to assess signal detection, and co\u2010occurrence patterns of adverse events were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 41\u2009551\u2009306 adverse event reports, 2\u2009095\u2009847 were related to antidiabetic medications. Safety signals for muscle atrophy were detected with sulfonylureas (ROR: 1.2, 95% CI: 1.01\u20131.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042), GLP\u20101 analogues\u00a0(ROR: 1.2, 95% CI: 1.02\u20131.41,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031) and SGLT2 inhibitors (ROR: 1.5, 95% CI: 1.19\u20131.78,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). SGLT2 inhibitors also showed a signal for sarcopenia (ROR: 6.2, 95% CI: 3.71\u201310.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Biguanides demonstrated signals for muscular weakness (ROR: 1.6, 95% CI: 1.54\u20131.71,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and motor function decline (ROR: 1.7, 95% CI: 1.41\u20132.13,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Thiazolidinediones, glinides, DPP\u20104 inhibitors and alpha\u2010glucosidase inhibitors showed no safety signals for the examined adverse events. Additionally, co\u2010occurrence analysis revealed frequent associations between muscle atrophy and nausea\/vomiting, falls and decreased appetite across different drug classes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings indicate notable differences in the profiles of muscle atrophy\u2013related adverse events among major classes of antidiabetic drugs, suggesting that drug selection may influence the risk of muscle function decline in patients. Clinicians should consider these safety profiles when prescribing antidiabetic therapies; however, causal relationships cannot be inferred solely from pharmacovigilance data. Further studies are warranted to establish causality between antidiabetic drug use and muscle\u2010related adverse events and to elucidate the underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70251","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T01:40:06Z","timestamp":1776217206000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Muscle Atrophy\u2010Related Adverse Events of Antidiabetic Drug Classes: A Pharmacovigilance Analysis Using VigiBase Data"],"prefix":"10.1002","volume":"17","author":[{"given":"Shiho","family":"Ueta","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics University of Tokushima Graduate School of Biomedical Sciences  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2033-4246","authenticated-orcid":false,"given":"Takahiro","family":"Niimura","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics University of Tokushima Graduate School of Biomedical Sciences  Tokushima Japan"},{"name":"Clinical Research Center for Developmental Therapeutics Tokushima University Hospital  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Goda","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics University of Tokushima Graduate School of Biomedical Sciences  Tokushima Japan"},{"name":"Department of Clinical Pharmacology and Therapeutics, Graduate School of Biomedical and Heath Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Graduate School of Pharmaceutical Sciences Nagoya City University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohiro","family":"Iwata","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Okayama University Hospital  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuaki","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Okayama University Hospital  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Kawada","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics University of Tokushima Graduate School of Biomedical Sciences  Tokushima Japan"},{"name":"Department of Pharmacy Tokushima University Hospital  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Miyata","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics University of Tokushima Graduate School of Biomedical Sciences  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuka","family":"Aizawa","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics University of Tokushima Graduate School of Biomedical Sciences  Tokushima Japan"},{"name":"Clinical Research Center for Developmental Therapeutics Tokushima University Hospital  Tokushima Japan"},{"name":"Department of Pharmacy Tokushima University Hospital  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics University of Tokushima Graduate School of Biomedical Sciences  Tokushima Japan"},{"name":"Clinical Research Center for Developmental Therapeutics Tokushima University Hospital  Tokushima Japan"},{"name":"Department of Pharmacy Shimane University Hospital  Izumo Shimane Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Hamano","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Okayama University Hospital  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Chuma","sequence":"additional","affiliation":[{"name":"Department of Hospital Pharmacy and Pharmacology Asahikawa Medical University  Asahikawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Izawa\u2010Ishizawa","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics University of Tokushima Graduate School of Biomedical Sciences  Tokushima Japan"},{"name":"Department of Health and Nutrition, Faculty of Human Life Science Shikoku University  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Zamami","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Okayama University Hospital  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Ishizawa","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Therapeutics University of Tokushima Graduate School of Biomedical Sciences  Tokushima Japan"},{"name":"Clinical Research Center for Developmental Therapeutics Tokushima University Hospital  Tokushima Japan"},{"name":"Department of Pharmacy Tokushima University Hospital  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"94","article-title":"Muscle Atrophy in Patients With Type 2 Diabetes Mellitus: 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