The risk of developing coronary artery disease or congestive heart failure, and overall mortality, in type 2 diabetic patients receiving rosiglitazone, pioglitazone, metformin, or sulfonylureas: a retrospective analysis

Pantalone, Kevin M.; Kattan, Michael W.; Yu, Changhong; Wells, Brian J.; Arrigain, Susana; Jain, Anil K.; Atreja, Ashish; Zimmerman, Robert S.

doi:10.1007/s00592-008-0090-3

Cited by 113 publications

(77 citation statements)

References 21 publications

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“…Observational data regarding the rate of heart failure with the use of SUs has been mixed, with two studies (25,26) finding an association between SU treatment and an increased rate of heart failure compared with metformin treatment, and one study (27) finding no association between SU treatment and heart failure in the context of a case-control analysis compared with no SU exposure. Beyond heart failure, the increased risk of other cardiovascular events with SU therapy is better established in clinical trials (28) and observational studies (29,30).…”

Section: Discussionmentioning

confidence: 99%

Association Between Hospitalization for Heart Failure and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes: An Observational Study

Johnston

Ghannam

et al. 2016

Diabetes Care

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OBJECTIVETo examine, among patients with type 2 diabetes, the association between hospitalization for heart failure (hHF) and treatment with dipeptidyl peptidase 4 inhibitors (DPP-4is) versus sulfonylureas (SUs), and treatment with saxagliptin versus sitagliptin. RESEARCH DESIGN AND METHODSThis was a retrospective, observational study using a U.S. insurance claims database. Patients initiated treatment between 1 August 2010 and 30 August 2013, and had no use of the comparator treatments in the prior 12 months (baseline). Each comparison consisted of patients matched 1:1 on a propensity score. Time to each outcome was compared between matched groups using Cox models. Analyses were stratified by the presence of baseline cardiovascular disease (CVD). Secondary analyses examined associations between comparator treatments and other selected cardiovascular events. RESULTSAfter matching, the study included 218,556 patients in comparisons of DPP-4i and SU, and 112,888 in comparisons of saxagliptin and sitagliptin. The hazard ratios (HRs) of hHF were as follows: DPP-4i versus SU (reference): HR 0.95 (95% CI 0.78-1.15), P = 0.580 for patients with baseline CVD; HR 0.59 (95% CI 0.38-0.89), P = 0.013 for patients without baseline CVD; saxagliptin versus sitagliptin (reference): HR 0.95 (95% CI 0.70-1.28), P = 0.712 for patients with baseline CVD; HR 0.99 (95% CI 0.56-1.75), P = 0.972 for patients without baseline CVD. Comparisons of the individual secondary and composite cardiovascular outcomes followed a similar pattern. CONCLUSIONSIn patients with type 2 diabetes, there was no association between hHF, or other selected cardiovascular outcomes, and treatment with a DPP-4i relative to SU or treatment with saxagliptin relative to sitagliptin.

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Section: Discussionmentioning

confidence: 99%

Association Between Hospitalization for Heart Failure and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes: An Observational Study

Johnston

Ghannam

et al. 2016

Diabetes Care

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“…Moreover, considering the potential adverse effects attributed to some drugs [6,7], the clinical importance of physical activity, as well as that of therapeutic education [8] is even increasing. However, the terms ''physical activity'' and ''exercise'' denote two different concepts [9].…”

Section: Introductionmentioning

confidence: 99%

Exercise for the management of type 2 diabetes: a review of the evidence

et al. 2009

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The aim is to critically review the more relevant evidence on the interrelationships between exercise and metabolic outcomes. The research questions addressed in the recent specific literature with the most relevant randomized controlled trials, meta-analysis and cohort studies are presented in three domains: aerobic exercise, resistance exercise, combined aerobic and resistance exercise. From this review appear that the effects of aerobic exercise are well established, and interventions with more vigorous aerobic exercise programs resulted in greater reductions in HbA 1c , greater increase in VO 2max and greater increase in insulin sensitivity. Considering the available evidence, it appears that resistance training could be an effective intervention to help glycemic control, especially considering that the effects of this form of intervention are comparable with what reported with aerobic exercise. Less studies have investigated whether combined resistance and aerobic training offers a synergistic and incremental effect on glycemic control; however, from the available evidences appear that combined exercise training seems to determine additional change in HbA 1c that can be seen significant if compared with aerobic training alone and resistance training alone.

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“…Previous investigations have found that in comparison to metformin monotherapy, sulfonylurea monotherapy increases the risk of coronary artery disease, congestive heart failure and mortality. 26,27 In the present study, metformin monotherapy was associated with a 31% (RR: 0.69) reduction in death from any cause, whereas combination therapy was associated with a 23% (RR: 0.77) reduction. The former is in agreement with the results of a recent meta-analysis of 40 randomized controlled trials, where metformin was associated with a decreased risk (OR: 0.74, 95%CI: 0.62, 0.89) of cardiovascular mortality compared to other OHAs or placebo.…”

Section: Discussionmentioning

confidence: 71%

Combination therapy with sulfonylureas and metformin and the prevention of death in type 2 diabetes: a nested case‐control study

Azoulay

Schneider‐Lindner

Dell’Aniello

et al. 2010

Pharmacoepidemiology and Drug

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SUMMARYPurpose To determine whether combination of sulfonylureas and metformin increases the risk of death from any cause in patients with type 2 diabetes. Methods A nested case-control study was conducted within a population-based cohort from the UK General Practice Research Database (GPRD). The cohort included patients over the age of 40 who were prescribed a first oral hypoglycaemic agent between 1 January 1988 and 30 June 2008. Cases included all patients who deceased during follow-up. Up to 10 controls were matched to each case on year of birth, date of cohort entry (AE1 year) and duration of follow-up. Conditional logistic regression was used to estimate rate ratios (RRs) of death from any cause associated with the use of combination of sulfonylureas and metformin, relative to sulfonylurea monotherapy. Results The cohort comprised 84 231 users of oral hypoglycaemic agents, of whom 14 996 died from any cause during a mean of 4.3 years of follow-up (mortality rate 4.1 per 100 per year). Patients currently exposed to a combination of sulfonylureas and metformin were at a decreased risk of death from any cause compared to patients exposed to sulfonylurea monotherapy (adjusted RR: 0.77, 95%CI: 0.70, 0.85). Similar results were obtained for patients currently exposed to metformin monotherapy (adjusted RR: 0.70, 95%CI: 0.64, 0.75) when compared to sulfonylurea monotherapy. Patients had to be exposed to the combination therapy for at least 4 months prior to index date to experience a lower risk of mortality compared to sulfonylurea monotherapy. Conclusions The combination of sulfonylureas and metformin does not increase the risk of death. In contrast, it may moderately reduce this risk compared to sulfonylurea monotherapy.

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The risk of developing coronary artery disease or congestive heart failure, and overall mortality, in type 2 diabetic patients receiving rosiglitazone, pioglitazone, metformin, or sulfonylureas: a retrospective analysis

Cited by 113 publications

References 21 publications

Association Between Hospitalization for Heart Failure and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes: An Observational Study

Association Between Hospitalization for Heart Failure and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes: An Observational Study

Exercise for the management of type 2 diabetes: a review of the evidence

Combination therapy with sulfonylureas and metformin and the prevention of death in type 2 diabetes: a nested case‐control study

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