Sodium-glucose cotransporter 2 inhibitors and the risk of venous thromboembolism: A population-based cohort study.
Br J Clin Pharmacol
; 89(9): 2902-2914, 2023 09.
Article
en En
| MEDLINE
| ID: mdl-37183930
ABSTRACT
AIMS:
The cardiovascular benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2Is) result from their complex impact on coronary and arterial vessels. However, their effect on veins and the risk of venous thromboembolism (VTE) remains unclear. Meta-analysis of trials has suggested no significant change in risk, but observational studies on the topic are scarce. Our objective was to determine if the use of SGLT2Is, compared to the use of dipeptidyl peptidase 4 inhibitors (DPP-4Is), is associated with the risk of VTE among patients with type 2 diabetes.METHODS:
Using the Clinical Practice Research Datalink linked to hospitalization and vital statistics databases, we conducted a retrospective cohort study using a prevalent new-user design. SGLT2Is were matched to DPP-4I users on calendar time, diabetes treatment intensity, duration of previous DPP-4I use and time-conditional high-dimensional propensity score. Cox proportional hazard models estimated the hazard ratio (HR) for VTE with SGLT2Is versus DPP-4Is.RESULTS:
SGLT2I use was not associated with an increased risk of VTE (HR 0.65, 95% confidence interval [CI] 0.34 to 1.25). This finding was consistent among prevalent (HR 0.47, 95% CI 0.16 to 1.42) and incident (HR 0.75, 95% CI 0.33 to 1.72) new users.CONCLUSIONS:
We found that SGLT2Is were not associated with an increased risk of VTE compared to DPP-4Is. Although we observed a numerically decreased risk of VTE with SGLT2Is, estimates were accompanied by wide 95% CIs. Nonetheless, given the morbidity associated with VTE, our results provide some reassurance regarding the safety of SGLT2Is with respect to VTE.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Diabetes Mellitus Tipo 2
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Tromboembolia Venosa
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Inhibidores de la Dipeptidil-Peptidasa IV
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Br J Clin Pharmacol
Año:
2023
Tipo del documento:
Article
País de afiliación:
Canadá