Association between SGLT2 inhibitor use and the risk of vertebral augmentation after initial osteoporotic vertebral fracture in patients with type 2 diabetes.
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are widely used in patients with type 2 diabetes mellitus (T2DM), but their influence on post-fracture outcomes remains unclear. This study aimed to evaluate the association between SGLT2 inhibitor use and the risk of vertebral augmentation after an initial osteoporotic vertebral compression fracture (VCF) in patients with T2DM and osteoporosis.
This retrospective cohort study used data from the TriNetX Global Collaborative Network. Adults with T2DM, osteoporosis, and a first documented VCF were identified. Patients who received SGLT2 inhibitors within 6 months prior to the fracture were compared with non-users. Individuals with prior vertebral augmentation, vertebral malignancy, or inflammatory spondylopathies were excluded. Propensity score matching (1:1) was performed based on demographics, comorbidities, and concurrent medications. The primary outcome was vertebral augmentation within 6 months following the index fracture.
After matching, 1757 patients were included in each cohort with well-balanced baseline characteristics. Within 6 months after the initial VCF, vertebral augmentation was performed in 12.5% of SGLT2 inhibitor users and 9.3% of non-users. SGLT2 inhibitor use was associated with a higher likelihood of vertebral augmentation (odds ratio 1.40; 95% confidence interval 1.13-1.73; p = 0.002).
In patients with T2DM and osteoporosis, SGLT2 inhibitor use was associated with an increased likelihood of vertebral augmentation following an initial osteoporotic vertebral fracture, suggesting potential differences in post-fracture clinical course or management intensity.
This retrospective cohort study used data from the TriNetX Global Collaborative Network. Adults with T2DM, osteoporosis, and a first documented VCF were identified. Patients who received SGLT2 inhibitors within 6 months prior to the fracture were compared with non-users. Individuals with prior vertebral augmentation, vertebral malignancy, or inflammatory spondylopathies were excluded. Propensity score matching (1:1) was performed based on demographics, comorbidities, and concurrent medications. The primary outcome was vertebral augmentation within 6 months following the index fracture.
After matching, 1757 patients were included in each cohort with well-balanced baseline characteristics. Within 6 months after the initial VCF, vertebral augmentation was performed in 12.5% of SGLT2 inhibitor users and 9.3% of non-users. SGLT2 inhibitor use was associated with a higher likelihood of vertebral augmentation (odds ratio 1.40; 95% confidence interval 1.13-1.73; p = 0.002).
In patients with T2DM and osteoporosis, SGLT2 inhibitor use was associated with an increased likelihood of vertebral augmentation following an initial osteoporotic vertebral fracture, suggesting potential differences in post-fracture clinical course or management intensity.