Obesity, type 2 diabetes (T2D), and weight loss are associated with increased fragility fracture risk. Meanwhile, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for obesity, T2D, and weight management. A retrospective study evaluated the association between GLP-1 RA initiation and 3-year fragility fracture risk compared with dipeptidyl peptidase-4 inhibitor (DPP-4i) initiation in 133,606 patients with T2D (Mean age: 63.2 years in the GLP-1 RA group and 63.8 years in the DPP-4i group). GLP-1 RA initiation was associated with lower fragility fracture risk than DPP-4i initiation (HR, 0.79).
Risk reduction was significant in year 1 (HR, 0.72) and year 2 (HR, 0.77), with attenuation by year 3 (HR, 0.94). The largest risk reductions were observed for vertebral fractures (HR, 0.68) and hip or femur fractures (HR, 0.70). In a sensitivity analysis stratified by…
