Comparative safety and effectiveness of sitagliptin in patients with type 2 diabetes: retrospective population based cohort study

被引：60

作者：

Eurich, D. T. ^{[1
,2
]}

Simpson, S. ^{[2
,3
]}

Senthilselvan, A. ^{[1
]}

Asche, C. V. ^{[4
,5
]}

Sandhu-Minhas, J. K. ^{[2
]}

McAlister, F. A. ^{[6
,7
]}

机构：

[1] Univ Alberta, Sch Publ Hlth, Dept Publ Hlth Sci, Edmonton, AB T6G 2G3, Canada

[2] Univ Alberta, Alliance Canadian Hlth Outcomes Res Diabet, Edmonton, AB T6G 2E1, Canada

[3] Univ Alberta, Fac Pharm & Pharmaceut Sci, Edmonton, AB T6G 2B7, Canada

[4] Univ Illinois, Coll Med Peoria, Ctr Hlth Outcomes, Peoria, IL 61656 USA

[5] Univ Illinois, Coll Pharm, Dept Pharm Adm, Chicago, IL 60612 USA

[6] Univ Alberta, Fac Med & Dent, Dept Med, Edmonton, AB T6G 2B7, Canada

[7] Univ Alberta, Edmonton, AB T6G 2B7, Canada

来源：

BMJ-BRITISH MEDICAL JOURNAL | 2013年 / 346卷

基金：

加拿大健康研究院;

关键词：

DIPEPTIDYL PEPTIDASE-4 INHIBITORS; INCRETIN-BASED THERAPIES; CARDIOVASCULAR OUTCOMES; ACUTE-PANCREATITIS; GLYCEMIC CONTROL; MORTALITY; METFORMIN; RISK; SULFONYLUREA; EXENATIDE;

D O I：

10.1136/bmj.f2267

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To determine if the use of sitagliptin in newly treated patients with type 2 diabetes is associated with any changes in clinical outcomes. Design Retrospective population based cohort study. Setting Large national commercially insured US claims and integrated laboratory database. Participants Inception cohort of new users of oral antidiabetic drugs between 2004 and 2009 followed until death, termination of medical insurance, or December 31 2010. Main outcome measure Composite endpoint of all cause hospital admission and all cause mortality, assessed with time varying Cox proportional hazards regression after adjustment for demographics, clinical and laboratory data, pharmacy claims data, healthcare use, and time varying propensity scores. Results The cohort included 72 738 new users of oral antidiabetic drugs (8032 (11%) used sitagliptin; 7293 (91%) were taking it in combination with other agents) followed for a total of 182 409 patient years. The mean age was 52 (SD 9) years, 54% (39 573) were men, 11% (8111) had ischemic heart disease, and 9% (6378) had diabetes related complications at the time their first antidiabetic drug was prescribed. 14 215 (20%) patients met the combined endpoint. Sitagliptin users showed similar rates of all cause hospital admission or mortality to patients not using sitagliptin (adjusted hazard ratio 0.98, 95% confidence interval 0.91 to 1.06), including patients with a history of ischemic heart disease (adjusted hazard ratio 1.10, 0.94 to 1.28) and those with estimated glomerular filtration rate below 60 mL/min (1.11, 0.88 to 1.41). Conclusions Sitagliptin use was not associated with an excess risk of all cause hospital admission or death compared with other glucose lowering agents among newly treated patients with type 2 diabetes. Most patients prescribed sitagliptin in this cohort were concordant with clinical practice guidelines, in that it was used as add-on treatment.

引用

页数：10

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