Risk of hospitalization and death associated with sodium glucose cotransporter-2 inhibitors: A comparison with five other classes of antidiabetic drugs - 24/03/22
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Highlights |
• | We conducted a population-based cohort study comparing SGLT2i users to users of five other classes of antidiabetic drugs (DPP4i, sulfonylureas, thiazolidinediones, GLP1-Receptors agonists, and insulin), to assess the risk of all-cause hospitalization and all-cause death. |
• | SGLT2i initiation was associated with a decreased risk of all-cause hospitalization and all-cause death when compared to DPP4i, sulfonylureas, and insulin. |
• | The associations were non-significant for GLP-1 RAs and thiazolidinediones for both outcomes. |
Abstract |
Aim |
We assessed the risk of all-cause hospitalization and all-cause death associated with the use of Sodium Glucose Cotransporter-2 inhibitors (SGLT2i).
Methods |
Population-based propensity scores-matched cohort study of new users of metformin who subsequently initiated SGLT2i compared to those who initiated dipeptidyl peptidase-4 inhibitors (DPP4i) (primary comparison), sulfonylureas, thiazolidinediones, GLP1-Receptors agonists, and insulin, respectively. Alberta (Canada) health administrative data and United Kingdom Clinical Practice Research Datalink (CPRD) data were used to assess the study outcomes. Conditional Cox regressions were performed to assess the risk of each outcome, separately for each dataset and then results were combined using random-effects meta-analysis.
Results |
For SGLT2i versus DPP4i, 7531 and 1647 SGLT2i-DPP4i matched pairs were analyzed in Alberta and CPRD data respectively. The mean age of patients was 56 and 57 years, and 39% and 43% were females, respectively in Alberta and CPRD cohorts. Compared with DPP-4-i, SGLT2i use was associated with a significant lower risk of all-cause hospitalization (combined hazard ratio (HR): 0.84, 95% confidence interval (95%CI): 0.75–0.95), and all-cause death (0.56, 0.38–0.83). SGLT2i use was also associated with a significant lower risk of all-cause hospitalization and all-cause death when compared to sulfonylureas (HRs: 0.80, 95%CI: 0.71–0.90 and 0.56, 95%CI: 0.38–0.82, respectively) and insulin (HRs: 0.55, 95%CI: 0.41–0.74, and 0.33, 95%CI: 0.24–0.46, respectively).
Conclusions |
SGLT2i initiation was associated with a decreased risk of all-cause hospitalization and all-cause death when compared to DPP4i, sulfonylureas, and insulin.
Le texte complet de cet article est disponible en PDF.Keywords : All-cause death, Antidiabetic drugs, Cohort study, Hospitalization, Sodium glucose co-transporter inhibitors (SGLT2i)
Plan
Vol 48 - N° 2
Article 101305- mars 2022 Retour au numéro
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