SGLT-2 inhibitor drug class has been a game changer in the treatment in of type 2 in its novel approach and more recently in terms of cardiovascular and renal benefits. At the same time, warnings such as fracture risk (specific to canagliflozin) have arisen previously in an overall safe drug class (when prescribed appropriately). While data from Canagliflozin Cardiovascular Assessment Study (CANVAS) showed a small but significant fracture risk increase with canagliflozin, a recent large population based database (aka real world data) did NOT find an associated increased fracture risk with SGLT-2 inhibitors. It is important to note that person with Paget’s disease, osteomalacia or hyperparathyroidism (risk factors for fractures) were excluded from this database review. The controversy over fracture risk will continue although using common sense in prescribing can go a long way in lowering fracture risk with this drug class. Please click below if you are interested in more details regarding this real world data.
https://care.diabetesjournals.org/content/early/2019/07/10/dc19-0849
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