Once-weekly glucagon-like peptide-1 receptor agonists vs dipeptidyl peptidase-4 inhibitors: cardiovascular effects in people with diabetes and cardiovascular disease.
Adult
Humans
Dipeptidyl-Peptidase IV Inhibitors
/ adverse effects
Diabetes Mellitus, Type 2
/ diagnosis
Cardiovascular Diseases
/ diagnosis
Glucagon-Like Peptide-1 Receptor
/ agonists
Risk Factors
Glucagon-Like Peptide 1
/ therapeutic use
Myocardial Infarction
/ diagnosis
Ischemic Stroke
Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
/ therapeutic use
Hypoglycemic Agents
/ adverse effects
Atherosclerotic cardiovascular disease
Glucagon-like peptide-1 receptor agonists
Major adverse cardiovascular events
Myocardial infarction
Stroke
Type 2 diabetes
Journal
Cardiovascular diabetology
ISSN: 1475-2840
Titre abrégé: Cardiovasc Diabetol
Pays: England
ID NLM: 101147637
Informations de publication
Date de publication:
20 Nov 2023
20 Nov 2023
Historique:
received:
27
09
2023
accepted:
03
11
2023
medline:
27
11
2023
pubmed:
21
11
2023
entrez:
21
11
2023
Statut:
epublish
Résumé
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which have proven cardiovascular benefits, are recommended in people with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD). However, there is limited real-world evidence comparing the effects of once-weekly (OW) GLP-1 RAs and dipeptidyl peptidase-4 inhibitors (DPP-4is). This observational cohort study (1/1/2017-9/30/2021) used data from the Optum Clinformatics Time to occurrence of ischemic stroke, myocardial infarction (MI), or their composite and ASCVD-related and all-cause HCRU and medical costs were investigated. Baseline characteristics were balanced using inverse probability of treatment weighting. Survival analyses were conducted to compare risks during exposure. OW GLP-1 RA users (weighted N = 25,287) had 26%, 22%, and 24% lower risk of ischemic stroke, MI, and their composite, respectively, compared with DPP-4i users (weighted N = 39,684; all P < 0.01). Compared with DPP-4i users, OW GLP-1 RA users had 25% and 26% lower ASCVD-related and all-cause hospitalization costs, 19% and 23% lower ASCVD-related and all-cause medical costs, 23% and 27% fewer ASCVD-related and all-cause hospitalizations, 13% and 8% fewer ASCVD-related and all-cause outpatient visits, and 8% fewer all-cause ER visits (all P < 0.01). In adults with T2D and ASCVD, OW GLP-1 RAs are associated with reduced stroke and MI risks and ASCVD-related and all-cause HCRU and costs vs DPP-4is.
Sections du résumé
BACKGROUND
BACKGROUND
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which have proven cardiovascular benefits, are recommended in people with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD). However, there is limited real-world evidence comparing the effects of once-weekly (OW) GLP-1 RAs and dipeptidyl peptidase-4 inhibitors (DPP-4is). This observational cohort study (1/1/2017-9/30/2021) used data from the Optum Clinformatics
METHODS
METHODS
Time to occurrence of ischemic stroke, myocardial infarction (MI), or their composite and ASCVD-related and all-cause HCRU and medical costs were investigated. Baseline characteristics were balanced using inverse probability of treatment weighting. Survival analyses were conducted to compare risks during exposure.
RESULTS
RESULTS
OW GLP-1 RA users (weighted N = 25,287) had 26%, 22%, and 24% lower risk of ischemic stroke, MI, and their composite, respectively, compared with DPP-4i users (weighted N = 39,684; all P < 0.01). Compared with DPP-4i users, OW GLP-1 RA users had 25% and 26% lower ASCVD-related and all-cause hospitalization costs, 19% and 23% lower ASCVD-related and all-cause medical costs, 23% and 27% fewer ASCVD-related and all-cause hospitalizations, 13% and 8% fewer ASCVD-related and all-cause outpatient visits, and 8% fewer all-cause ER visits (all P < 0.01).
CONCLUSIONS
CONCLUSIONS
In adults with T2D and ASCVD, OW GLP-1 RAs are associated with reduced stroke and MI risks and ASCVD-related and all-cause HCRU and costs vs DPP-4is.
Identifiants
pubmed: 37985992
doi: 10.1186/s12933-023-02051-8
pii: 10.1186/s12933-023-02051-8
pmc: PMC10662529
doi:
Substances chimiques
Dipeptidyl-Peptidase IV Inhibitors
0
Glucagon-Like Peptide-1 Receptor
0
Glucagon-Like Peptide 1
89750-14-1
Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
EC 3.4.14.-
Hypoglycemic Agents
0
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
319Informations de copyright
© 2023. The Author(s).
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