https://www.medpagetoday.com/surgery/orthopedics/118936?xid=nl_mpt_morningbreak2025-12-11&mh=04b3fab0856809eb8d5b4eee8e5ed787&zdee=gAAAAABm4vbh613aknD-ZiAqg-dNwwghuyj6DR2QMHH-Rfh8t-RWx7r0ZDVK29f8wQZXfUsq-6EAjjP6ux-f_mG4G-2QQsGPta21WayO65bX-HvmO2KePfk%3D&utm_source=Sailthru&utm_medium=email&utm_campaign=MorningBreak_121125&utm_term=NL_Gen_Int_Daily_News_Update_active
Very interesting data from a cohort study which is of course hypothesis generating. Are these data strong enough to warrant a large randomized study?
Perhaps. There are suggestive pre-clinical data which supported an exploratory fracture endpoint in REWIND. Please see the attached protocol in Lancet:v 394, p 121-130, 13 Jul 2013.
If yes, because of MACE 3 benefits observed with GLP-1 RA, the study would need to have the placebo arm take an another class of diabetes medications with similar CVS benefits such as SGLT2 inhibitors.
I think this possible study would need to be large, 1000’s of subjects, over many years , ~ 5, and conducted in subjects at increased risk of fracture.
If such a study was properly conducted, it would lead first to more long term safety data about these agents. And second perhaps novel efficacy data.
