Another study has linked thiazolidinediones, a class of diabetes drugs which include Avandia and Actos, with a higher risk of bone fractures, specifically in women. This study was conducted by the Center for Health Services Research at Henry Ford Hospital and published in the February issue of the Journal of Clinical Endocrinology & Metabolism.
Fractures are just one of a growing number of problems associated with medications like Avandia and Actos, and previous research has found that this class of drugs also can increase risk of congestive heart failure hospitalization.
In a statement, L. Keoki Williams, M.D., MPH, the senior author of the Henry Ford Hospital study, noted that there are other medication options available to treat insulin resistance in patients with type 2 diabetes, and encouraged patients to talk with their physician about these options. For patients whose physicians feel treatment with a thiazolidinedione is appropriate, screening for bone loss and prophylactic therapy to prevent bone loss and fractures may also be needed, Dr. Williams said.
To determine the relationship between thiazolidinedione use and fracture risk in patients with type 2 diabetes, researchers conducted a retrospective study from Jan. 2, 2000 to May 31, 2007 of 19,070 Henry Ford patients – 9,620 women and 9,450 men. During the study period, 4,511 patients had at least one prescription fill for a thiazolidinedione. The researchers used electronically maintained medical claims data to identify non-traumatic bone fractures.
According to the study, after taking a thiazolidinedione for one year, women are 50 percent more likely to have a bone fracture than patients not taking thiazolidinediones. And those at the greatest risk for fractures from the drugs use are women older than 65.
Men, regardless of age, were not at an increased risk for fractures, although some other recent studies have suggested an association between thiazolidinedione use and increased fracture risk in men.
The researchers also found thiazolidinedione use in women to be associated with fractures of the upper extremity and distal lower extremity. Similar findings were observed in treated women older than 65, who were shown to have a 70 percent increased risk for developing fractures. Typically, osteoporosis-related fractures involve the vertebra and hip.