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Lower Cardiorenal Risk with Sodium-Glucose Cotransporter-2 Inhibitors versus Dipeptidyl Peptidase-4 Inhibitors in Type 2 Diabetes Patients without Cardiovascular and Renal Diseases: A large multinational observational study

Birkeland, KI; Bodegard, J; Banerjee, A; Kim, DJ; Norhammar, A; Eriksson, JW; Thuresson, M; ... Kadowaki, T; + view all (2021) Lower Cardiorenal Risk with Sodium-Glucose Cotransporter-2 Inhibitors versus Dipeptidyl Peptidase-4 Inhibitors in Type 2 Diabetes Patients without Cardiovascular and Renal Diseases: A large multinational observational study. Diabetes, Obesity and Metabolism , 23 (1) pp. 75-85. 10.1111/dom.14189. Green open access

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Abstract

BACKGROUND: We compared new use of sodium-glucose cotransporter-2 inhibitor (SGLT2i) vs. dipeptidyl peptidase-4 inhibitor (DPP4i) and the risk of cardiorenal disease, heart failure (HF) or chronic kidney disease (CKD), in type 2 diabetes patients without history of prevalent cardiovascular and renal disease, defined as cardiovascular- and renal disease (CVRD) free, managed in routine clinical practice. METHODS: In this observational cohort study, patients were identified in electronic health records in England, Germany, Japan, Norway, South Korea and Sweden, from 2012 to 2018. A total of 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 death. 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 were mean 56 years, 43% women and 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 death; HR (95% CI) 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 lower risk of heart failure and chronic kidney disease versus DPP4i in T2D patients otherwise free from both cardiovascular and renal disease.

Type: Article
Title: Lower Cardiorenal Risk with Sodium-Glucose Cotransporter-2 Inhibitors versus Dipeptidyl Peptidase-4 Inhibitors in Type 2 Diabetes Patients without Cardiovascular and Renal Diseases: A large multinational observational study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/dom.14189
Publisher version: https://doi.org/10.1111/dom.14189
Language: English
Additional information: © 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10110264
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