Lower heart failure and chronic kidney disease risks associated with sodium-glucose cotransporter-2 inhibitor use in Japanese type 2 diabetes patients without established cardiovascular and renal diseases.
Diabetes Obes Metab
; 23 Suppl 2: 19-27, 2021 04.
Article
em En
| MEDLINE
| ID: mdl-33835641
ABSTRACT
AIMS:
To examine heart failure (HF) and chronic kidney disease (CKD) risks reduction associated with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) compared to other glucose-lowering drugs (oGLD) in the early stage of type 2 diabetes patients without established cardiovascular or renal diseases (CVRD-free T2D). MATERIALS ANDMETHODS:
We performed an observational cohort study using a Japanese hospital claims registry, Medical Data Vision. CVRD-free T2D patients were identified between 1 April 2014 and 30 September 2018. SGLT-2i and oGLD new users (and dipeptidyl peptidase 4 inhibitors [DPP-4i] separately) were subjected to 11 propensity-score matching analysis. Hazard ratios (HRs) of cardiorenal disease (HF and/or CKD), HF, CKD, stroke, myocardial infarction (MI), and all-cause mortality, were estimated using unadjusted Cox regression.RESULTS:
A total of 108 362 CVRD-free patients including 54 181 SGLT-2i and 54 181 oGLD users were matched. Baseline characteristics were well balanced (mean age 59.1 years, 63% male, and follow-up 1.50 years [162 970 patient-years]). Compared to oGLD group, SGLT-2i group had lower risk of cardiorenal disease, HF, CKD, stroke, and all-cause mortality with HRs (95% confidence intervals) 0.55 (0.49-0.61), 0.73 (0.61-0.87), 0.45 (0.39-0.52), 0.69 (0.59-0.81), and 0.52 (0.46-0.58), respectively, while no difference in MI. These were consistent in 11 propensity-score matching analysis between SGLT-2i and DPP-4i users (n = 17 232 in each group).CONCLUSIONS:
In Japanese CVRD-free T2D patients, SGLT-2i initiation was associated with lower risk of cardiorenal diseases, stroke, and all-cause mortality compared to oGLD, suggesting preventive effect of SGLT-2i treatment in the early stage of T2D patients without CVRD manifestation.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Preparações Farmacêuticas
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Doenças Cardiovasculares
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Diabetes Mellitus Tipo 2
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Insuficiência Renal Crônica
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Inibidores da Dipeptidil Peptidase IV
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Inibidores do Transportador 2 de Sódio-Glicose
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Insuficiência Cardíaca
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article