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Whereas in Germany, the market access differs from the systems followed in many other countries as no pricing and reimbursement approval is required during launch of a new therapy

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The conflicting data in some clinical studies may be explained by various factors: [1] most cohort studies lacked individual validation of fractures as primary outcomes, [2] the studies had short follow-up duration and [3] did not consider important risk factors for osteoporosis such as BMD (even though BMD is not a good method for diagnosing osteoporosis in T2DM), and [4] some studies included medications that affect fracture risk, such as corticosteroids or antidepressants

EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update