{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:09:32Z","timestamp":1793045372752,"version":"4.5.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","funder":[{"DOI":"10.13039\/501100004381","name":"Western University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004381","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008958","name":"Lawson Health Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008958","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010564","name":"Academic Medical Organization of Southwestern Ontario","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008093","name":"Schulich School of Medicine and Dentistry","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Sodium-glucose cotransporter-2 (SGLT2) inhibitors have been associated with a higher risk of skeletal fractures in some randomized, placebo-controlled trials. Secondary hyperparathyroidism and increased bone turnover (also common in CKD) may contribute to the observed fracture risk. We aimed to determine if SGLT2 inhibitor use associates with a higher risk of fractures compared with dipeptidyl peptidase-4 (DPP-4) inhibitors, which have no known association with fracture risk. We hypothesized that this risk, if present, would be greatest in patients with lower eGFR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>\n                      We conducted a population-based cohort study in Ontario, Canada between 2015 and 2019 using linked provincial administrative data to compare the incidence of fracture between new users of SGLT2 inhibitors and DPP-4 inhibitors. We used inverse probability of treatment weighting on the basis of propensity scores to balance the two groups of older adults (\u226566 years of age) on indicators of baseline health. We compared the 180- and 365-day cumulative incidence rates of fracture between groups. Prespecified subgroup analyses were conducted by eGFR category (\u226590, 60 to &lt;90, 45 to &lt;60, and 30 to &lt;45 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ). Weighted hazard ratios were obtained using Cox proportional hazard regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After weighting, we identified a total of 38,994 new users of a SGLT2 inhibitor and 37,449 new users of a DPP-4 inhibitor and observed a total of 342 fractures at 180 days and 689 fractures at 365 days. The weighted 180- and 365-day risks of a fragility fracture did not significantly differ between new users of a SGLT2 inhibitor versus a DPP-4 inhibitor: weighted hazard ratio, 0.95 (95% confidence interval, 0.79 to 1.13) and weighted hazard ratio, 0.88 (95% confidence interval, 0.88 to 1.00), respectively. There was no observed interaction between fracture risk and eGFR category (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.53).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort study of older adults, starting a SGLT2 inhibitor versus DPP-4 inhibitor was not associated with a higher risk of skeletal fracture, regardless of eGFR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.16171221","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T13:03:15Z","timestamp":1654174995000},"page":"835-842","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":34,"title":["Fracture Risk of Sodium-Glucose Cotransporter-2 Inhibitors in Chronic Kidney 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A.","family":"Weir","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Evaluative Sciences (ICES), London, Ontario, Canada"},{"name":"Department of Medicine, Western University, London, Ontario, Canada"},{"name":"Lawson Health Research Institute, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9636-5597","authenticated-orcid":false,"given":"Kristin K.","family":"Clemens","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Evaluative Sciences (ICES), London, Ontario, Canada"},{"name":"Department of Medicine, Western University, London, Ontario, Canada"},{"name":"Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada"},{"name":"Lawson Health Research Institute, London, Ontario, Canada"},{"name":"St. Joseph\u2019s Health Care London, London, Ontario, 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