Lower cardiorenal risk withsodium-glucosecotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes without cardiovascular and renal diseases: A large multinational observational study

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Lower cardiorenal risk withsodium-glucosecotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes without cardiovascular and renal diseases : A large multinational observational study

Birkeland, Kare I. (author): Oslo Univ Hosp, Oslo, Norway.;Univ Oslo, Oslo, Norway.

Bodegard, Johan (author): AstraZeneca, Fredrik Selmersvei 6, N-0601 Oslo, Norway.

Banerjee, Amitava (author): UCL, Inst Hlth Informat, London, England.;Univ Coll London Hosp, Dept Cardiol, London, England.

Kim, Dae Jung (author): Ajou Univ, Sch Med, Dept Endocrinol & Metab, Suwon, South Korea.

Norhammar, Anna (author): Karolinska Institutet

Eriksson, Jan (author): Uppsala universitet,Klinisk diabetologi och metabolism

Thuresson, Marcus (author): Statisticon AB, Uppsala, Sweden.

Okami, Suguru (author): AstraZeneca, Osaka, Japan.

Ha, Kyoung Hwa (author): Ajou Univ, Sch Med, Dept Endocrinol & Metab, Suwon, South Korea.

Kossack, Nils (author): Wissensch Inst Gesundheitsokon & Gesundheitssyste, Leipzig, Germany.

Mamza, Jil Billy (author): AstraZeneca, Luton, Beds, England.

Zhang, Ruiqi (author): AstraZeneca, Luton, Beds, England.

Yajima, Toshitaka (author): AstraZeneca, Osaka, Japan.

Komuro, Issei (author): Univ Tokyo, Grad Sch Med, Dept Cardiovasc Med, Tokyo, Japan.

Kadowaki, Takashi (author): Tranomon Hosp, Tokyo, Japan.

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Oslo Univ Hosp, Oslo, Norway;Univ Oslo, Oslo, Norway. AstraZeneca, Fredrik Selmersvei 6, N-0601 Oslo, Norway. (creator_code:org_t)

2020-09-28
2021
English.
In: Diabetes, obesity and metabolism. - : John Wiley & Sons. - 1462-8902 .- 1463-1326. ; 23:1, s. 75-85

Related links:: https://doi.org/10.1...; show more...; https://uu.diva-port... (primary) (Raw object); https://onlinelibrar...; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Aims We compared the new use of sodium-glucose cotransporter-2 inhibitor (SGLT2i) versus dipeptidyl peptidase-4 inhibitor (DPP4i) and the risk of cardiorenal disease, heart failure (HF) or chronic kidney disease (CKD), in patients with type 2 diabetes without a history of prevalent cardiovascular and renal disease, defined as cardiovascular and renal disease (CVRD) free, managed in routine clinical practice. Materials and methods In this observational cohort study, patients were identified from electronic health records from England, Germany, Japan, Norway, South Korea and Sweden, during 2012-2018. In total, 1 006 577 CVRD-free new users of SGLT2i or DPP4i were propensity score matched 1:1. Unadjusted Cox regression was used to estimate hazard ratios (HRs) for outcomes: cardiorenal disease, HF, CKD, stroke, myocardial infarction (MI), cardiovascular and all-cause mortality. Results Baseline characteristics were well balanced between the treatment groups (n = 105 130 in each group) with total follow-up of 187 955 patient years. Patients had a mean age of 56 years, 43% were women and they were indexed between 2013 and 2018. The most commonly used agents were dapagliflozin (91.7% of exposure time) and sitagliptin/linagliptin (55.0%), in the SGLT2i and DPP4i, groups, respectively. SGLT2i was associated with lower risk of cardiorenal disease, HF, CKD, all-cause and cardiovascular mortality; HR (95% confidence interval), 0.56 (0.42-0.74), 0.71 (0.59-0.86), 0.44 (0.28-0.69), 0.67 (0.59-0.77), and 0.61 (0.44-0.85), respectively. No differences were observed for stroke [0.87 (0.69-1.09)] and MI [0.94 (0.80-1.11)]. Conclusion In this multinational observational study, SGLT2i was associated with a lower risk of HF and CKD versus DPP4i in patients with type 2 diabetes otherwise free from both cardiovascular and renal disease.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Keyword

dapagliflozin
diabetic nephropathy
DPP-IV inhibitor
heart failure
observational study
SGLT2 inhibitor

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art (subject category)

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By the author/editor: Birkeland, Kare ...; Bodegard, Johan; Banerjee, Amitav ...; Kim, Dae Jung; Norhammar, Anna; Eriksson, Jan; show more...; Thuresson, Marcu ...; Okami, Suguru; Ha, Kyoung Hwa; Kossack, Nils; Mamza, Jil Billy; Zhang, Ruiqi; Yajima, Toshitak ...; Komuro, Issei; Kadowaki, Takash ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Endocrinology an ...

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