Encore Presentations
Sunday, October 13, 2024
12:45 PM–02:15 PM
Abstract
ABSTRACT
Background
Recent clinical guidelines for type 2 diabetes mellitus (T2DM) have shifted towards a more individualized approach, with a particular emphasis on the role of sodium-glucose cotransporter 2 (SGLT2) inhibitors. These drugs have not only shown promising results in cardiovascular benefits but also in renal outcomes. However, despite their established efficacy, there remains a significant gap in research that comprehensively covers both renal effects and safety outcomes. This study aims to address this deficiency by evaluating the effectiveness of SGLT2 inhibitors on renal outcomes compared to dipeptidyl peptidase 4 (DPP4) inhibitors, utilizing large-scale nationwide claims data from South Korea.
Methods
This is a retrospective observational cohort study investigating nationwide claim data from the Health Insurance Review and Assessment Services Common Data Model database in Korea. It compared clinical outcomes between type 2 diabetes mellitus patients maintained on SGLT2 inhibitor and those maintained on DPP4 inhibitor based on metformin treatment. Propensity score matching (PSM) was utilized to ensure comparability between groups, and hazard ratios were calculated using the Cox proportional hazards model. Primary outcomes (any new-onset kidney events, acute kidney injury, chronic kidney disease, and kidney failure), secondary outcomes (infection, hemodynamic status, and fracture), all-cause mortality and cardiovascular outcomes were evaluated.
Results
13,649 patients were enrolled in SGLT2 inhibitor group, and 35,043 patients were enrolled in DPP4 inhibitor group after propensity score matching. The SGLT2 inhibitor group had a lower risk of kidney outcomes, AKI, and CDK (HR 0.88, 0.61 and 0.74, respectively) than DPP4 inhibitor group. For the secondary outcomes, the risk of genital infection was higher, and the risk of hyperkalemia was lower in the SGLT2 inhibitor group than DPP4 inhibitor group (HR 2.38, and 0.49, respectively). All-cause mortality and cardiovascular outcomes were estimated to be the same as the results of previous studies.
Conclusions
The present study was a retrospective study using large data sets, we confirmed that the SGLT2 inhibitor has lower the risk of new-onset kidney outcomes than DPP4 inhibitor in the T2DM patients. The SGLT inhibitor groups were also has high incidence of genital infection and low incidence of hyperkalemia and hospitalization for heart failure.
Keywords
Diabetes mellitus, Kidney diseases, Sodium-glucose transporter 2 inhibitors, Dipeptidyl-Peptidase IV Inhibitors, Cardiovascular Diseases
Presenting Author
Sukhyang Lee PharmD, PhDAjou University
Authors
Junhyuk Chang PharmD
Ajou University
Heejung Choi MD
Ajou University, School of Medicine
Chungsoo Kim PharmD
Ajou University
Rae Woong Park MD, PhD
Ajou University, School of Medicine