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This study explored whether tirzepatide therapy is linked to an increased risk of osteoporosis and fragility fractures as opposed to other glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes mellitus (T2DM) or obesity.
Patients receiving tirzepatide show a higher incidence of osteoporosis and fragility fractures than those treated with other GLP-1 RAs.
This study explored whether tirzepatide therapy is linked to an increased risk of osteoporosis and fragility fractures as opposed to other glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with type 2 diabetes mellitus (T2DM) or obesity.
This retrospective real-world cohort study analyzed data from the TriNetX global research network, including 459,886 adults with T2DM or obesity who initiated tirzepatide or alternative GLP-1 RAs. A 1:1 propensity score–matched analysis was carried out to minimize baseline differences. The key endpoint was a composite outcome of novel-onset osteoporosis or fragility fracture, assessed over a 14-month follow-up period.
After matching, 66,329 subjects were included in each treatment group. Tirzepatide use was linked with a markedly higher risk of osteoporosis or fragility fractures than other GLP-1 RAs (hazard ratio [HR] 1.44). Tirzepatide users also demonstrated an increased likelihood of initiating osteoporosis treatment (HR 1.61). When compared with nonusers, tirzepatide was linked to a markedly heightened risk of the composite outcome (HR 1.48), whereas other GLP-1 RAs illustrated no clinically meaningful risk increase (HR 1.07).
Initiation of tirzepatide was connected with increased risk of osteoporosis and fragility fractures compared with other GLP-1 RAs, highlighting the importance of bone health monitoring in patients receiving tirzepatide for diabetes or obesity care.
Diabetes Research and Clinical Practice
Association of tirzepatide use with risk of osteoporosis compared with other GLP-1 receptor agonists: A retrospective cohort study using the TriNetX database
Yung-Han Hsu et al.
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