Concern over certain antidiabetic drugs

[7 May 2007 - 17h25]
[mis à jour le 9 May 2007 à 11h25]

Because of their direct effect on a protein that controls bone mass, energy expenditure and glucose metabolism, it appears that certain antidiabetic drugs may have adverse effects on bone tissue. Does this mean that certain treatments against diabetes could promote the development of osteoporosis ?

This worrying information – particularly so for elderly diabetics – was recently aired at the 34th European Calcified Tissue Symposium (ECTS) currently taking place in Copenhagen, Denmark. Beata Lecka-Czernik, a gerontologist at the University Hospital in Little Rock, Arkansas, stated that “bone is a target for roziglitazone” – roziglitazone being one of the most recent oral antidiabetic drugs, introduced only 5 years ago.

In Copenhagen her presentation went beyond the work she had presented on the subject in 2004. At that time she had shown that this drug caused a significant reduction in bone mass … in mice. How could this be explained? By the effect of the drug on a very particular protein known to specialists as PPAR-Gamma and which acts as a kind of “one-man band” regulating glycemic balance – obviously an issue in diabetes – and bone metabolism. Anything that affects bone metabolism and especially the balance between the destruction of old bone and the construction of new bone can dangerously reduce our bone mass… and even lead to osteoporosis, which is a particular risk after the age of 65.

Dr Lecka-Czernik believes that “the results obtained ‘in vivo’ in mice suggest that (this type of treatment) could lead to a significant risk of adverse effects on the human skeleton”. This is a worrying piece of information as the treatment of the most elderly diabetics is often complex. But this downside may in fact have an upside too as it could mean the possibility of developing new treatments against osteoporosis.

Meanwhile, this data comes at a time when, concerning a different matter, the French Health Products Safety Agency (the AFSSaPS) is sending out a letter to consultants regarding antidiabetic drugs in the same family. In this the Agency describes an “increase in the incidence of bone fractures in patients treated with pioglitazone”.

Source : from our special correspondent at the 34th European Calcified Tissue Symposium, Copenhagen 5–9 May 2007, AFSSaPS, 7 May 2007

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