Sulfonylureas and fracture risk in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.

OBJECTIVE

To evaluate the association between sulfonylureas and fracture risk in patients with type 2 diabetes mellitus (T2DM).

METHODS

PubMed, Web of Science, the Cochrane Library and Embase were systematically searched for observational studies evaluating sulfonylurea-associated fracture risk in patients with T2DM. Pooled relative risk (RR) and its 95% confidence interval (CI) were calculated.

RESULTS

Twelve observational studies involving 5,854,139 patients were included. Sulfonylurea use was significantly associated with increased risks of overall fractures (RR = 1.28; 95% CI: 1.11-1.47) and osteoporotic fractures (RR = 1.38; 95% CI: 1.05-1.80). Site-specific analyses revealed a 23% increase in hip fracture risk (RR = 1.23; 95% CI: 1.03-1.46) and a 47% increase in vertebral fracture risk (RR = 1.47; 95% CI: 1.24-1.74). Fracture risk profiles varied across sulfonylurea subtypes.

CONCLUSION

Sulfonylureas are associated with a significant increase in the overall risk of fractures and the risk of osteoporotic fractures in patients with T2DM, and this risk is particularly prominent in hip and vertebral fractures.