4.7 Article

Lower risk of hospitalization for heart failure, kidney disease and death with sodium-glucose co-transporter-2 inhibitors compared with dipeptidyl peptidase-4 inhibitors in type 2 diabetes regardless of prior cardiovascular or kidney disease: A retrospective cohort study in UK primary care

Journal

DIABETES OBESITY & METABOLISM
Volume 23, Issue 10, Pages 2207-2214

Publisher

WILEY
DOI: 10.1111/dom.14437

Keywords

cardiovascular disease; clinical trial; dapagliflozin; diabetes complications; dipeptidyl peptidase-4 inhibitor; heart failure

Funding

  1. AstraZeneca
  2. National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM)
  3. NIHR Leicester Biomedical Research Centre (BRC)
  4. NIHR Nottingham Biomedical Research Centre
  5. NIHR Nottingham Clinical Research Facilities
  6. NIHR
  7. British Medical Association
  8. UK Research and Innovation
  9. Innovative Medicines Initiative-2 (BigData@Heart Consortium by the European Union's Horizon 2020 research and innovation programme) [116074]
  10. Innovative Medicines Initiative-2 (BigData@Heart Consortium by the EFPIA) [116074]

Ask authors/readers for more resources

The study found that in patients with type 2 diabetes, sodium-glucose co-transporter-2 inhibitors (SGLT2is) were associated with significantly lower risk of all-cause mortality, cardiovascular death, and hospitalization for heart failure or chronic kidney disease compared to dipeptidyl peptidase-4 inhibitors (DPP4is).
Aim To assess if sodium-glucose co-transporter-2 inhibitors (SGLT2is) reduce the risk of all-cause mortality, cardiovascular death and hospitalization for heart failure (HF) or chronic kidney disease (CKD) to a greater extent than dipeptidyl peptidase-4 inhibitors (DPP4is) in people with type 2 diabetes (T2D) with or without established cardiovascular and/or renal disease (CVRD). Methods This retrospective cohort study propensity-matched 24 438 patients receiving an SGLT2i 1:1 to a patient receiving a DDP4i, stratified based on the presence of CVRD. The primary outcomes were the time to each of the following: all-cause mortality, cardiovascular death or hospitalization for HF, myocardial infarction, stroke and CKD. Results Overall, SGLT2is were associated with reductions in all-cause mortality, cardiovascular mortality, hospitalization for HF and hospitalization for CKD compared with DPP4is. In patients with no CVRD history, SGLT2is were associated with reductions in all-cause mortality (HR 0.71, 95% CI 0.57-0.88; P = .002), hospitalization for HF (HR 0.76, 95% CI 0.59-0.98; P = .035) and hospitalization for CKD (HR 0.75, 95% CI 0.63-0.88; P < .001). In patients with established cardiovascular disease (CVD) or at high risk, SGLT2is were associated with reductions in all-cause mortality (HR 0.69, 95% CI 0.59-0.82; P < .001), cardiovascular mortality (HR 0.76, 95% CI 0.62-0.95; P = .014), hospitalization for HF (HR 0.73, 95% CI 0.63-0.85; P < .001), hospitalization for stroke (HR 0.75, 95% CI 0.59-0.94; P = .013) and hospitalization for CKD (HR 0.49, 95% CI 0.43-0.54; P < .001). Conclusion There was consistency across subgroups and sensitivity analyses. SGLT2is were associated with a reduced risk of all-cause mortality and hospitalization for HF and CKD compared with DPP4-is, highlighting the need to introduce SGLT2is early in the management of patients with T2D.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available