diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13029diaendo-13029Research ArticleОригинальные исследованияOriginal StudiesСнижение частоты сердечно-сосудистых заболеваний у пациентов с сахарным диабетом 2 типа, получавших ингибитор натрий-глюкозного котранспортера-2, по сравнению с ингибитором дипептидилпептидазы-4: ретроспективный анализ реальных данных из административной базы данных в ЯпонииReduction in cardiovascular disease events in patients with type 2 diabetes mellitus treated with a sodium–glucose cotransporter 2 inhibitor versus a dipeptidyl peptidase-4 inhibitor: A real-world retrospective administrative database analysis in Japanhttps://orcid.org/0000-0002-6049-3236KashiwagiA.KashiwagiA.

Shiga

Shiga

kashiwagi@seikoukai-sc.or.jpShojiS.ShojiS.

Tokyo

Tokyo

OnozawaS.OnozawaS.

Tokyo

Tokyo

KosakaiY.KosakaiY.

Tokyo

Tokyo

WarataniM.WarataniM.

Tokyo

Tokyo

ItoY.ItoYu.

Tokyo

Tokyo

Omi Medical CenterЯпонияOmi Medical CenterJapanMedical Affairs, Astellas Pharma Inc.ЯпонияMedical Affairs, Astellas Pharma Inc.JapanAdvanced Informatics & Analytics, Astellas Pharma Inc.ЯпонияAdvanced Informatics & Analytics, Astellas Pharma Inc.Japan202315052023262157171Copyright © Kashiwagi A., Shoji S., Onozawa S., Kosakai Y., Waratani M., Ito Y., 20232023Kashiwagi A., Shoji S., Onozawa S., Kosakai Y., Waratani M., Ito Y.Kashiwagi A., Shoji S., Onozawa S., Kosakai Y., Waratani M., Ito Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13029ЦЕЛИ

ЦЕЛИ. Оценить преимущество ингибиторов натрий-глюкозного котранспортера-2 (иНГЛТ-2) по сравнению с ингибиторами дипептидилпептидазы-4 (иДПП-4) в снижении частоты сердечно-сосудистых заболеваний (ССЗ) у пациентов с сахарным диабетом 2 типа (СД2) с ССЗ и без них.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ. В этом ретроспективном когортном исследовании использовались административные данные японских больниц из базы данных Medical Data Vision (с января 2015 г. по апрель 2020 г.). В исследование были включены пациенты с СД2 (n=625 739), впервые начавшие принимать иНГЛТ-2 (n=57 070; 9,1%) или иДПП-4 (n=568 669; 90,9%). Исходы включали госпитализацию по поводу сердечной недостаточности (гСН), смерть от всех причин и сочетание гСН и смерти от всех причин. Для сравнения рисков сердечно-сосудистых событий между группами лечения были рассчитаны отношения рисков (ОР) с использованием модели пропорциональных рисков Кокса с обратным взвешиванием вероятностей.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. По сравнению с иДПП-4, иНГЛТ-2 были связаны со значительным снижением риска гСН среди пациентов без ССЗ в анамнезе (ОР 0,507; 95% доверительный интервал [ДИ] 0,283–0,907), но не в полной когорте или у пациентов с ССЗ в анамнезе. иНГЛТ-2 были связаны со значительным снижением риска смерти от всех причин (ОР 0,592; 95% ДИ 0,481–0,729) и сочетания гСН и смерти от всех причин (ОР 0,712; 95% ДИ 0,613–0,826) по сравнению с иДПП-4 в полной когорте; аналогичные результаты наблюдались среди пациентов с ССЗ и без них.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. В этом исследовании реальных данных у лиц, получавших иНГЛТ-2, по сравнению с данными лиц, получавших иДПП-4, было выявлено значительное снижение частоты гСН, смерти от всех причин и их сочетания у пациентов с СД2 без ССЗ в анамнезе.

AIMS/INTRODUCTION

AIMS/INTRODUCTION: To evaluate the benefit of sodium–glucose cotransporter 2 inhibitors (SGLT2i) versus dipeptidyl peptidase-4 inhibitors (DPP4i) in reducing cardiovascular disease (CVD) events in patients with type 2 diabetes mellitus with and without a CVD history.

MATERIALS AND METHODS

MATERIALS AND METHODS: This retrospective cohort study used Japanese hospital administrative data from the Medical Data Vision database (January 2015 to April 2020). Patients with type 2 diabetes mellitus (n=625,739) who were new users of an SGLT2i (n=57,070; 9.1%) or DPP4i (n=568,669; 90.9%) were included. Outcomes included hospitalization for heart failure (hHF), all-cause death (ACD) and the composite of hHF or ACD. Hazard ratios (HR) were calculated using the inverse probability weighting Cox proportional hazards model to compare CVD event risks between treatment groups.

RESULTS

RESULTS: Compared with DPP4i, SGLT2i was associated with a significant reduction in hHF risk among patients without a CVD history (HR 0.507, 95% confidence interval 0.283–0.907), but not in the full cohort or those with a CVD history. SGLT2i was associated with a significant risk reduction of ACD (HR 0.592, 95% confidence interval 0.481–0.729) and the composite of hHF or ACD (HR 0.712, 95% confidence interval 0.613–0.826), compared with DPP4i in the full cohort; similar results were observed among patients with and without a CVD history.

CONCLUSION

CONCLUSION: In this real-world study, SGLT2i versus DPP4i was associated with a significant reduction in hHF, ACD and hHF or ACD events in patients with type 2 diabetes mellitus without a CVD history.

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The authors declare that there are no conflicts of interest present.