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Glitazone 'increases fracture risk by 61%'

By Lilian Anekwe

The apparent increase in risk of fractures in patients with type 2 diabetes who are treated with glitazones may be specific to those on pioglitazone, a new study from the University of British Columbia has found.

University of British Columbia researchers found that, overall, use of glitazones was associated with a 28% increased risk of peripheral fractures compared with use of a sulphonylurea.

But the risk of fracture was as high as 61% for men and 77% in women taking pioglitazone compared with a sulphonylurea, while there was no observed risk in patients treated with rosiglitazone.

The University of British Columbia researchers said ‘mounting evidence of harm' from glitazones should act as a brake to future prescribing of the drugs.

Professor Ken Bassett, professor of family practice at the University of British Columbia said: ‘Our study adds to growing literature on clinically significant harm from glitazones compared with alternative oral hypoglycemic drugs. Our position is that glitazones have not been shown to result in net clinical benefit in any instance.'

Takeda, the manufacturer of pioglitazone, said the increased risk of bone fracture in some patients was already reflected in the prescribing information.

A spokeperson told Pulse: ‘To date, there have been no studies published designed to study the effect of pioglitazone on fractures. Takeda is currently conducting a study in this field.'

The new Canadian research, published in Archives of Internal Medicine last week, analysed data from 74,000 patients who began treatment with a sulphonylurea and 4,445 patients who began treatment with a glitazone.

Dr Roger Gadsby, a GP in Warwick and member of the NICE type 2 diabetes guideline development group, said: ‘There is a risk of factures in women with glitazones, but it's important the difficulties with sulphonylureas are not swept under the carpet - in particular hypoglycaemia.'

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