Incretin-Based Therapies and Diabetic Retinopathy: Real-World Evidence in Older U.S. Adults

Wang, Tiansheng; Hong, Jisu; Gower, Emily W.; Pate, Virginia; Garg, Seema; Buse, John B.; Stürmer, Til

doi:10.2337/dc17-2285

Cited by 38 publications

(35 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our analysis of the FAERS database indicates that there is no signal for the association between GLP-1RA and DR, which is consistent with the Exenatide Study of Cardiovascular Event Lowering (EXSCEL) and Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trials and our recent cohort study ( 1 ). A recent FAERS analysis ( 2 ) comparing GLP-1RA with other GLDs and stratified by insulin also suggested no signal.…”

supporting

confidence: 86%

“…Other trials of glucagon-like peptide 1 receptor agonists (GLP-1RA) showed a numerically higher incidence of DR AEs for liraglutide but not exenatide. However, these trials did not systematically assess DR. Our population-based cohort study of older U.S. adults suggested that GLP-1RA use for approximately 1 year does not increase DR risk ( 1 ). As current evidence on GLP-1RA–associated DR risk is still limited, we conducted a disproportionality analysis of the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database to examine the association between GLP-1RA and DR events.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Assessing the Association Between GLP-1 Receptor Agonist Use and Diabetic Retinopathy Through the FDA Adverse Event Reporting System

Wang

Tang

et al. 2018

Diabetes Care

Self Cite

View full text Add to dashboard Cite

supporting

confidence: 86%

mentioning

confidence: 99%

Assessing the Association Between GLP-1 Receptor Agonist Use and Diabetic Retinopathy Through the FDA Adverse Event Reporting System

Wang

Tang

et al. 2018

Diabetes Care

Self Cite

View full text Add to dashboard Cite

“…The presence of risk factors, such as smoking, in claims data has high specificity but low sensitivity (35). However, Wang et al (36) have demonstrated that clinical measures such as hemoglobin A 1c are well balanced between DPP4i versus SU and DPP4i versus TZD comparisons in their ACNU study.…”

Section: Limitationsmentioning

confidence: 98%

Dipeptidyl Peptidase 4 Inhibitors and Risk of Inflammatory Bowel Disease: Real-world Evidence in U.S. Adults

et al. 2019

Self Cite

View full text Add to dashboard Cite

A recent study raises concerns that dipeptidyl peptidase 4 inhibitors (DPP4i) are associated with increased risk of inflammatory bowel disease (IBD). We evaluated the association between new use of DPP4i and IBD risk compared with other secondline antihyperglycemics. RESEARCH DESIGN AND METHODS We implemented an active-comparator, new-user cohort design using two U.S. administrative claims databases for commercially insured (MarketScan) and older adult (Medicare fee-for-service, 20% random sample) patients from January 2007 to December 2016. We identified patients, aged ‡18 years, who initiated DPP4i versus sulfonylureas (SUs) or initiated DPP4i versus thiazolidinediones (TZDs) and were without prior diagnosis, treatment, or procedure for IBD. The primary outcome was incident IBD, defined by IBD diagnosis preceded by colonoscopy and biopsy and followed by IBD treatment. We performed propensity score weighting to control for measured baseline confounding, estimated adjusted hazard ratios (aHRs [95% CI]) using weighted Cox proportional hazards models, and used randomeffects meta-analysis models to pool aHRs across cohorts. RESULTS We identified 895,747 eligible patients initiating DPP4i, SU, or TZD; IBD incidence rates ranged from 11.6 to 32.3/100,000 person-years. Over a median treatment duration of 1.09-1.69 years, DPP4i were not associated with increased IBD risk across comparisons. The pooled aHRs for IBD were 0.82 (95% CI 0.41-1.61) when comparing DPP4i (n 5 161,612) to SU (n 5 310,550) and 0.76 (0.46-1.26) when comparing DPP4i (n 5 205,570) to TZD (n 5 87,543). CONCLUSIONS Our population-based cohort study of U.S. adults with diabetes suggests that shortterm DPP4i treatment does not increase IBD risk. Dipeptidyl peptidase 4 inhibitors (DPP4i), a commonly prescribed second-line glucose-lowering drug (GLD) class, reduce hyperglycemia by increasing the levels of incretin hormones, which in turn increase insulin and decrease glucagon in a glucose-dependent fashion (1). DPP4, also known as CD26, is expressed on leukocytes and can inactivate various cytokines as well as act as a costimulator of T lymphocytes (2), thus raising concerns about potential immunologic effects of DPP4i (3). A recent

show abstract

“…With Type 2 Diabetes (SUSTAIN-6) showed an increased risk of diabetic retinopathy complications associated with semaglutide versus placebo among patients with a history of retinopathy, especially among those with insulin use (1). Although concerns have been raised regarding the safety of glucagon-like peptide 1 (GLP-1) receptor agonists in patients with existing retinopathy, subgroup analyses by retinopathy status at baseline have not been presented for other trials of GLP-1 receptor agonists; the two observational studies on GLP-1 receptor agonists and diabetic retinopathy performed to date have excluded patients with a history of retinopathy (2) or treatment of retinopathy (3).…”

Section: Post Hoc Analyses Of the Trial To Evaluate Cardiovascular Anmentioning

confidence: 99%

Glucagon-Like Peptide 1 Receptor Agonists and Risk of Diabetic Retinopathy Complications: Cohort Study in Nationwide Registers From Two Countries

et al. 2019

View full text Add to dashboard Cite

Incretin-Based Therapies and Diabetic Retinopathy: Real-World Evidence in Older U.S. Adults

Abstract: Our population-based cohort study of older U.S. adults with diabetes suggests that IBTs used for approximately 1 year do not increase the DR risk.

Cited by 38 publications

References 37 publications

Assessing the Association Between GLP-1 Receptor Agonist Use and Diabetic Retinopathy Through the FDA Adverse Event Reporting System

Assessing the Association Between GLP-1 Receptor Agonist Use and Diabetic Retinopathy Through the FDA Adverse Event Reporting System

Dipeptidyl Peptidase 4 Inhibitors and Risk of Inflammatory Bowel Disease: Real-world Evidence in U.S. Adults

Glucagon-Like Peptide 1 Receptor Agonists and Risk of Diabetic Retinopathy Complications: Cohort Study in Nationwide Registers From Two Countries

Contact Info

Product

Resources

About