Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors vs. Dipeptidyl Peptidase-4 (DPP4) Inhibitors for New-Onset Dementia: A Propensity Score-Matched Population-Based Study With Competing Risk Analysis

Mui, Jonathan V; Zhou, Jiandong; Lee, Sharen; Leung, Keith Sai Kit; Lee, Teddy Tai Loy; Chou, Oscar Hou In; Tsang, Shek Long; Wai, Abraham Ka Chung; Liu, Tong; Wong, Wing Tak; Chang, Carlin; Tse, Gary; Zhang, Qingpeng

doi:10.3389/fcvm.2021.747620

Cited by 48 publications

(45 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The patients were identified from the Clinical Data Analysis and Reporting System (CDARS), a territory‐wide database that centralizes patient information from individual local hospitals to establish comprehensive medical data, including clinical characteristics, disease diagnosis, laboratory results, and drug treatment details. The system has been previously used by both our team and other teams in Hong Kong to conduct population‐based cohort studies, 18,19 including those on diabetes mellitus 20,21 …”

Section: Methodsmentioning

confidence: 99%

“…The system has been previously used by both our team and other teams in Hong Kong to conduct population-based cohort studies, 18,19 including those on diabetes mellitus. 20,21 Clinical and biochemical data were extracted from CDARS for the present study. Patients' demographics include sex and age of initial drug use (baseline).…”

Section: Study Design and Populationmentioning

confidence: 99%

See 1 more Smart Citation

Incident heart failure and myocardial infarction in sodium‐glucose cotransporter‐2 vs. dipeptidyl peptidase‐4 inhibitor users

Zhou

Lee²,

Leung

et al. 2022

ESC Heart Failure

Self Cite

View full text Add to dashboard Cite

Aims This study aimed to compare the rates of major cardiovascular adverse events in sodium‐glucose cotransporter‐2 inhibitors (SGLT2I) and dipeptidyl peptidase‐4 inhibitors (DPP4I) users in a Chinese population. SGLT2I and DPP4I are increasingly prescribed for type 2 diabetes mellitus patients. However, few population‐based studies are comparing their effects on incident heart failure or myocardial infarction. Methods and results This was a population‐based retrospective cohort study using the electronic health record database in Hong Kong, including type 2 diabetes mellitus patients receiving either SGLT2I or DPP4I from 1 January 2015 to 31 December 2020. Propensity score matching was performed in a 1:1 ratio based on demographics, past comorbidities, and non‐SGLT2I/DPP4I medications with nearest neighbour matching (caliper = 0.1). Univariable and multivariable Cox models were used to identify significant predictors for new‐onset heart failure, new‐onset myocardial infarction, cardiovascular mortality, and all‐cause mortality. Sensitivity analyses with competing risk models and multiple propensity score matching approaches were conducted. A total of 41 994 patients (58.89% males, median admission age at 58 years old, interquartile range [IQR]: 51.2–65.3) were included with a median follow‐up of 5.6 years (IQR: 5.32–5.82). In the matched cohort, SGLT2I use was significantly associated with lower risks of new‐onset heart failure (hazard ratio [HR]: 0.73, 95% confidence interval [CI]: [0.66, 0.81], P < 0.0001), myocardial infarction (HR: 0.81, 95% CI: [0.73, 0.90], P < 0.0001), cardiovascular mortality (HR: 0.67, 95% CI: [0.53, 0.84], P < 0.001), and all‐cause mortality (HR: 0.26, 95% CI: [0.24, 0.29], P < 0.0001) after adjusting for significant demographics, past comorbidities, and non‐SGLT2I/DPP4I medications. Conclusions SGLT2 inhibitors are protective against adverse cardiovascular events including new‐onset heart failure, myocardial infarction, cardiovascular mortality, and all‐cause mortality. The prescription of SGLT2I is preferred when taken into consideration individual cardiovascular and metabolic risk profiles in addition to drug–drug interactions.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Study Design and Populationmentioning

confidence: 99%

Incident heart failure and myocardial infarction in sodium‐glucose cotransporter‐2 vs. dipeptidyl peptidase‐4 inhibitor users

Zhou

Lee²,

Leung

et al. 2022

ESC Heart Failure

Self Cite

View full text Add to dashboard Cite

show abstract

“…Animal studies indicated that SGLT2 significantly ameliorated cognitive decline in type 2 diabetic mice ( 152 , 155 ). A recent large propensity score-matched population-based study demonstrated that patients treated with SGLT2 inhibitors were associated with lower risks of dementia compared with when treated with DPP4 inhibitors ( 148 ). Simone et al also found that cognitive status did not change significantly during the 12 months of treatment of SGLT2 inhibitor ( 156 ).…”

Section: Prevention and Potential Therapeutic Options For CI In Hfmentioning

confidence: 99%

Cognitive Impairment in Heart Failure: Landscape, Challenges, and Future Directions

Yang

Sun

Wang

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Heart failure (HF) is a major global healthcare problem accounting for substantial deterioration of prognosis. As a complex clinical syndrome, HF often coexists with multi-comorbidities of which cognitive impairment (CI) is particularly important. CI is increasing in prevalence among patients with HF and is present in around 40%, even up to 60%, of elderly patients with HF. As a potent and independent prognostic factor, CI significantly increases the hospitalization and mortality and decreases quality of life in patients with HF. There has been a growing awareness of the complex bidirectional interaction between HF and CI as it shares a number of common pathophysiological pathways including reduced cerebral blood flow, inflammation, and neurohumoral activations. Research that focus on the precise mechanism for CI in HF is still ever insufficient. As the tremendous adverse consequences of CI in HF, effective early diagnosis of CI in HF and interventions for these patients may halt disease progression and improve prognosis. The current clinical guidelines in HF have begun to emphasize the importance of CI. However, nearly half of CI in HF is underdiagnosed, and few recommendations are available to guide clinicians about how to approach CI in patients with HF. This review aims to synthesize knowledge about the link between HF and cognitive dysfunction, issues pertaining to screening, diagnosis and management of CI in patients with HF, and emerging therapies for prevention. Based on data from current studies, critical gaps in knowledge of CI in HF are identified, and future research directions to guide the field forward are proposed.

show abstract

“…A nested case–control study by Wium-Andersen et al [ 18 ] found that SGLT2 inhibitors were associated with a lower OR of dementia. Moreover, Mui et al [ 94 ] reported that SGLT2 inhibitor users had a lower incidence of dementia than DPP-4 inhibitor users in a retrospective cohort study of patients with diabetes using SGLT2 or DPP-4 inhibitors from 1 January 2015 to 31 December 2019. The study cohort enrolled 13,276 SGLT2 inhibitor users and 36,544 DPP-4 inhibitor users, with a mean follow-up period of 472 days.…”

Section: Association Of Pharmacological and Pharmacokinetic Propertie...mentioning

confidence: 99%

The Effectiveness of Antidiabetic Drugs in Treating Dementia: A Peek into Pharmacological and Pharmacokinetic Properties

Ogura

Yamaguchi

2022

IJMS

View full text Add to dashboard Cite

Dementia dramatically affects the activities of daily living and quality of life; thus, many therapeutic approaches for overcoming dementia have been developed. However, an effective treatment regimen is yet to be developed. As diabetes is a well-known risk factor for dementia, drug repositioning and repurposing of antidiabetic drugs are expected to be effective dementia treatments. Several observational studies have been useful for understanding the effectiveness of antidiabetic drugs in treating dementia, but it is difficult to conclusively analyze the association between antidiabetic drug treatment and the risk of developing dementia after correcting for potential confounding factors. Mechanism-based approaches may provide a better understanding of the effectiveness of antidiabetic drugs for treating dementia. Since the peripheral circulation and the central nerve system are separated by the blood–brain barrier, it is important to understand the regulation of the central glucose metabolism. In this review, we discuss the pharmacological and pharmacokinetic properties of antidiabetic drugs in relation to treating dementia.

show abstract

Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors vs. Dipeptidyl Peptidase-4 (DPP4) Inhibitors for New-Onset Dementia: A Propensity Score-Matched Population-Based Study With Competing Risk Analysis

Cited by 48 publications

References 56 publications

Incident heart failure and myocardial infarction in sodium‐glucose cotransporter‐2 vs. dipeptidyl peptidase‐4 inhibitor users

Incident heart failure and myocardial infarction in sodium‐glucose cotransporter‐2 vs. dipeptidyl peptidase‐4 inhibitor users

Cognitive Impairment in Heart Failure: Landscape, Challenges, and Future Directions

The Effectiveness of Antidiabetic Drugs in Treating Dementia: A Peek into Pharmacological and Pharmacokinetic Properties

Contact Info

Product

Resources

About