Comparison Of The Long-Term Effects Of Liraglutide And Glimepiride Monotherapy On Bone Mineral Density In Patients With Type 2 Diabetes

Gilbert, Matthew P.; Marre, Michel; Holst, Jens J.; Garber, Alan J.; Baeres, Florian M.M.; Thomsen, Henrik F.; Pratley, Richard E.

doi:10.4158/ep15758.or

Cited by 51 publications

(32 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a clinical trial, 61 T2DM patients were divided into three groups randomly: liraglutide 1.8 mg/day or liraglutide 1.2 mg/day or glimepiride 8 mg/day. This research showed no significant differences in BMD among groups in drug use at 52 or 104 weeks (12). The 24-week use of exenatide in newly diagnosed and treatment-naive patients with T2DM presented no influence on BMD (13).…”

Section: The Impact Of Glp-1 On Bone Metabolismmentioning

confidence: 82%

The Impact of Glucagon-Like Peptide-1 on Bone Metabolism and Its Possible Mechanisms

et al. 2017

View full text Add to dashboard Cite

The impact of antidiabetic drugs on bone metabolism is drawing increasing attention due to the discovery of a correlation between type 2 diabetes mellitus (T2DM) and osteoporosis. Glucagon-like peptide-1 (GLP-1) receptor agonists are a novel and promising class of drugs for T2DM, which may also have clinical applications in bone tissue disorders. This review examines the impact of GLP-1 on bone metabolism, including enhancement of bone mineral density and improvement of bone quality. However, the precise effect of GLP-1 on fracture risk has not been unambiguously defined. This review also summarizes our current understanding of the mechanisms by which GLP-1 affects bone metabolism. GLP-1 may act on bone by promoting bone formation, inhibiting bone resorption, and affecting the coordination of the two processes. We describe molecular pathways and proteins, such as Wnt and calcitonin, that are associated with GLP-1 and bone tissue. The specific processes and related molecular mechanisms of the effects of GLP-1 on bone metabolism need to be further explored and clarified.

show abstract

Section: The Impact Of Glp-1 On Bone Metabolismmentioning

confidence: 82%

The Impact of Glucagon-Like Peptide-1 on Bone Metabolism and Its Possible Mechanisms

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Most initial studies were not designed to evaluate their impact on the risk of falls and subsequent bone fracture . However, regarding bone integrity, one recent very small ( n = 61 patients) prospective sub‐study (LEAD‐3) comparing liraglutide (1.8 [ n = 20] or 1.2 [ n = 23] mg/day) with the SU glimepiride ( n = 18; 8 mg/day), each as monotherapy, demonstrated that total BMD remained stable from baseline following 52 or 104 weeks of treatment with either of these medications …”

Section: Drugs and Bonementioning

confidence: 99%

“…The risk of fracture from SUs has, to date, predominately been associated with the risk of falls due to hypoglycemia with SU therapy, and not to a direct effect of the drugs on bone remodeling (bone turnover markers) or integrity (ie, BMD) . Because SUs increase both first and second phase insulin release by β‐cells (in a glycaemia‐independent manner), hypoglycemia is a known risk factor of the SUs.…”

Section: Drugs and Bonementioning

confidence: 99%

Diabetes pharmacotherapy and effects on the musculoskeletal system

Kalaitzoglou

Fowlkes

Popescu

et al. 2018

Diabetes Metabolism Res

View full text Add to dashboard Cite

Summary Persons with type 1 or type 2 diabetes have a significantly higher fracture risk than age‐matched persons without diabetes, attributed to disease‐specific deficits in the microarchitecture and material properties of bone tissue. Therefore, independent effects of diabetes drugs on skeletal integrity are vitally important. Studies of incretin‐based therapies have shown divergent effects of different agents on fracture risk, including detrimental, beneficial, and neutral effects. The sulfonylurea class of drugs, owing to its hypoglycemic potential, is thought to amplify the risk of fall‐related fractures, particularly in the elderly. Other agents such as the biguanides may, in fact, be osteo‐anabolic. In contrast, despite similarly expected anabolic properties of insulin, data suggests that insulin pharmacotherapy itself, particularly in type 2 diabetes, may be a risk factor for fracture, negatively associated with determinants of bone quality and bone strength. Finally, sodium‐dependent glucose co‐transporter 2 inhibitors have been associated with an increased risk of atypical fractures in select populations, and possibly with an increase in lower extremity amputation with specific SGLT2I drugs. The role of skeletal muscle, as a potential mediator and determinant of bone quality, is also a relevant area of exploration. Currently, data regarding the impact of glucose lowering medications on diabetes‐related muscle atrophy is more limited, although preclinical studies suggest that various hypoglycemic agents may have either aggravating (sulfonylureas, glinides) or repairing (thiazolidinediones, biguanides, incretins) effects on skeletal muscle atrophy, thereby influencing bone quality. Hence, the therapeutic efficacy of each hypoglycemic agent must also be evaluated in light of its impact, alone or in combination, on musculoskeletal health, when determining an individualized treatment approach. Moreover, the effect of newer medications (potentially seeking expanded clinical indication into the pediatric age range) on the growing skeleton is largely unknown. Herein, we review the available literature regarding effects of diabetes pharmacotherapy, by drug class and/or by clinical indication, on the musculoskeletal health of persons with diabetes.

show abstract

“…Considering that sulfonylureas likely have the lowest impact on bone metabolism among the oral antidiabetics [23] and are not associated with changes in the risk of fracture [2], the results of this study suggest that the iDPP-4 vildagliptin has a similar bone metabolism safety profile and presumably does not increase the risk of fracture, as the sulfonylurea gliclazide. Liraglutide, a GLP-1 receptor agonist with similar features as the DPP-4 inhibitors, has previously demonstrated a similar BMD pattern to a sulfonylurea [24]. …”

Section: Discussionmentioning

confidence: 99%

Vildagliptin has the same safety profile as a sulfonylurea on bone metabolism and bone mineral density in post-menopausal women with type 2 diabetes: a randomized controlled trial

Vianna

Lacerda

Pechmann

et al. 2017

Diabetol Metab Syndr

View full text Add to dashboard Cite

Background Several antidiabetic therapies affect bone metabolism. Sulfonylureas have the lowest impact on bone among oral antidiabetics. The objective of this study is to compare the effects of vildagliptin and gliclazide modified release (MR) on bone turnover markers (BTMs) and bone mineral density (BMD) in postmenopausal women with uncontrolled type 2 diabetes (T2D). Methods Forty-two postmenopausal women with uncontrolled T2D were randomly allocated into vildagliptin or gliclazide MR (control) groups. The primary endpoint was the change in the BTMs in months 6 and 12 compared with the baseline. The secondary endpoint was the variation in the BMD, which was assessed via dual-energy X-ray absorptiometry at the lumbar spine, femoral neck and total hip at baseline and month 12. Results After a 12-month treatment, the BTM serum carboxy-terminal telopeptide of type 1 collagen increased 0.001 ± 0.153 ng/mL in the vildagliptin group versus 0.008 ± 0.060 ng/mL in the gliclazide MR group ( p = 0.858). The serum osteocalcin, serum amino-terminal propeptide of procollagen type I and urinary amino-terminal telopeptide of type 1 collagen remained stable in both groups, and there was no statistically significant difference between the effect of vildagliptin and gliclazide MR on these variables. The lumbar spine BMD did not change in the vildagliptin or gliclazide MR groups after a 12-month treatment (0.000 ± 0.025 g/cm 2 versus −0.008 ± 0.036, respectively, p = 0.434). Furthermore, there was a similar lack of change in the femoral neck and total hip BMD values in both treatments. Conclusions Bone turnover markers and BMD remained unchanged after a 12-month treatment in both groups, which suggests that vildagliptin has the same safety profile as gliclazide MR on bone metabolism. Trial Registration ClinicalTrials.gov number NCT01679899 Electronic supplementary material The online version of this article (doi:10.1186/s13098-017-0232-2) contains supplementary material, which is available to authorized users.

show abstract

Comparison Of The Long-Term Effects Of Liraglutide And Glimepiride Monotherapy On Bone Mineral Density In Patients With Type 2 Diabetes

Cited by 51 publications

References 25 publications

The Impact of Glucagon-Like Peptide-1 on Bone Metabolism and Its Possible Mechanisms

The Impact of Glucagon-Like Peptide-1 on Bone Metabolism and Its Possible Mechanisms

Diabetes pharmacotherapy and effects on the musculoskeletal system

Vildagliptin has the same safety profile as a sulfonylurea on bone metabolism and bone mineral density in post-menopausal women with type 2 diabetes: a randomized controlled trial

Contact Info

Product

Resources

About