Dipeptidyl Peptidase-4 Inhibitors versus Other Antidiabetic Drugs Added to Metformin Monotherapy in Diabetic Retinopathy Progression: A Real World-Based Cohort Study
To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus, compared with sulfonylurea (SU) or thiazolidinedione (TZD). We identified 4,447 patients with DPP4i, 6,136...
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| Published in | Diabetes & metabolism journal Vol. 43; no. 5; pp. 640 - 648 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
Korean Diabetes Association / Daehan Dangnyobyeong Hakoe
01.10.2019
Korean Diabetes Association 대한당뇨병학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2233-6079 2233-6087 2233-6087 |
| DOI | 10.4093/dmj.2018.0137 |
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| Abstract | To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus, compared with sulfonylurea (SU) or thiazolidinedione (TZD).
We identified 4,447 patients with DPP4i, 6,136 with SU, and 617 with TZD in addition to metformin therapy from the database of Korean National Health Insurance Service between January 2013 and December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for DR progression. The progression of DR was defined by the procedure code of panretinal photocoagulation, intravitreal injection or vitrectomy; or the addition of diagnostic code of vitreous hemorrhage, retinal detachment, or neovascular glaucoma.
The age and sex-adjusted HR of DR progression was 0.74 for DPP4i add-on group compared with SU add-on group (95% confidence interval [CI], 0.62 to 0.89). This lower risk of DR progression remained significant after additional adjustments for comorbidities, duration of metformin therapy, intravitreal injections and calendar index year (HR, 0.80; 95% CI, 0.66 to 0.97).
This population-based cohort study showed that the use of DPP4i as add-on therapy to metformin did not increase the risk of DR progression compared to SU. |
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| AbstractList | To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus, compared with sulfonylurea (SU) or thiazolidinedione (TZD).
We identified 4,447 patients with DPP4i, 6,136 with SU, and 617 with TZD in addition to metformin therapy from the database of Korean National Health Insurance Service between January 2013 and December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for DR progression. The progression of DR was defined by the procedure code of panretinal photocoagulation, intravitreal injection or vitrectomy; or the addition of diagnostic code of vitreous hemorrhage, retinal detachment, or neovascular glaucoma.
The age and sex-adjusted HR of DR progression was 0.74 for DPP4i add-on group compared with SU add-on group (95% confidence interval [CI], 0.62 to 0.89). This lower risk of DR progression remained significant after additional adjustments for comorbidities, duration of metformin therapy, intravitreal injections and calendar index year (HR, 0.80; 95% CI, 0.66 to 0.97).
This population-based cohort study showed that the use of DPP4i as add-on therapy to metformin did not increase the risk of DR progression compared to SU. Background: To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progressionof diabetic retinopathy (DR) in patients with type 2 diabetes mellitus, compared with sulfonylurea (SU) or thiazolidinedione(TZD). Methods: We identified 4,447 patients with DPP4i, 6,136 with SU, and 617 with TZD in addition to metformin therapy from thedatabase of Korean National Health Insurance Service between January 2013 and December 2015. Cox proportional hazards regressionmodels were used to calculate hazard ratios (HRs) for DR progression. The progression of DR was defined by the procedurecode of panretinal photocoagulation, intravitreal injection or vitrectomy; or the addition of diagnostic code of vitreous hemorrhage,retinal detachment, or neovascular glaucoma. Results: The age and sex-adjusted HR of DR progression was 0.74 for DPP4i add-on group compared with SU add-on group(95% confidence interval [CI], 0.62 to 0.89). This lower risk of DR progression remained significant after additional adjustmentsfor comorbidities, duration of metformin therapy, intravitreal injections and calendar index year (HR, 0.80; 95% CI, 0.66 to 0.97). Conclusion: This population-based cohort study showed that the use of DPP4i as add-on therapy to metformin did not increasethe risk of DR progression compared to SU. KCI Citation Count: 19 To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus, compared with sulfonylurea (SU) or thiazolidinedione (TZD).BACKGROUNDTo investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus, compared with sulfonylurea (SU) or thiazolidinedione (TZD).We identified 4,447 patients with DPP4i, 6,136 with SU, and 617 with TZD in addition to metformin therapy from the database of Korean National Health Insurance Service between January 2013 and December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for DR progression. The progression of DR was defined by the procedure code of panretinal photocoagulation, intravitreal injection or vitrectomy; or the addition of diagnostic code of vitreous hemorrhage, retinal detachment, or neovascular glaucoma.METHODSWe identified 4,447 patients with DPP4i, 6,136 with SU, and 617 with TZD in addition to metformin therapy from the database of Korean National Health Insurance Service between January 2013 and December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for DR progression. The progression of DR was defined by the procedure code of panretinal photocoagulation, intravitreal injection or vitrectomy; or the addition of diagnostic code of vitreous hemorrhage, retinal detachment, or neovascular glaucoma.The age and sex-adjusted HR of DR progression was 0.74 for DPP4i add-on group compared with SU add-on group (95% confidence interval [CI], 0.62 to 0.89). This lower risk of DR progression remained significant after additional adjustments for comorbidities, duration of metformin therapy, intravitreal injections and calendar index year (HR, 0.80; 95% CI, 0.66 to 0.97).RESULTSThe age and sex-adjusted HR of DR progression was 0.74 for DPP4i add-on group compared with SU add-on group (95% confidence interval [CI], 0.62 to 0.89). This lower risk of DR progression remained significant after additional adjustments for comorbidities, duration of metformin therapy, intravitreal injections and calendar index year (HR, 0.80; 95% CI, 0.66 to 0.97).This population-based cohort study showed that the use of DPP4i as add-on therapy to metformin did not increase the risk of DR progression compared to SU.CONCLUSIONThis population-based cohort study showed that the use of DPP4i as add-on therapy to metformin did not increase the risk of DR progression compared to SU. Background To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus, compared with sulfonylurea (SU) or thiazolidinedione (TZD).* Methods We identified 4,447 patients with DPP4i, 6,136 with SU, and 617 with TZD in addition to metformin therapy from the database of Korean National Health Insurance Service between January 2013 and December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for DR progression. The progression of DR was defined by the procedure code of panretinal photocoagulation, intravitreal injection or vitrectomy; or the addition of diagnostic code of vitreous hemorrhage, retinal detachment, or neovascular glaucoma.* Results The age and sex-adjusted HR of DR progression was 0.74 for DPP4i add-on group compared with SU add-on group (95% confidence interval [CI], 0.62 to 0.89). This lower risk of DR progression remained significant after additional adjustments for comorbidities, duration of metformin therapy, intravitreal injections and calendar index year (HR, 0.80; 95% CI, 0.66 to 0.97).* Conclusion This population-based cohort study showed that the use of DPP4i as add-on therapy to metformin did not increase the risk of DR progression compared to SU. |
| Author | Ha, Kyoung Hwa Kim, Hyeon Chang Park, Sang Jun Chung, Yoo-Ri Lee, Kihwang Kim, Dae Jung |
| AuthorAffiliation | 4 Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea 1 Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea 2 Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea 3 Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea 5 Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea |
| AuthorAffiliation_xml | – name: 5 Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea – name: 2 Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea – name: 4 Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea – name: 3 Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea – name: 1 Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea |
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| CitedBy_id | crossref_primary_10_1002_14651858_CD013775_pub2 crossref_primary_10_1016_j_drudis_2020_01_008 crossref_primary_10_2337_dc22_2521 crossref_primary_10_3390_jcm10040705 crossref_primary_10_3390_biomedicines10020465 crossref_primary_10_3390_ph17121579 crossref_primary_10_1186_s12974_024_03283_5 crossref_primary_10_3389_fnins_2022_824054 crossref_primary_10_1016_j_xops_2024_100494 crossref_primary_10_3390_jcm13061797 crossref_primary_10_1111_dom_15367 crossref_primary_10_3390_ijms24010571 crossref_primary_10_4093_dmj_2019_0216 crossref_primary_10_4093_dmj_2019_0207 crossref_primary_10_1111_dom_15788 crossref_primary_10_1097_ICU_0000000000001038 crossref_primary_10_1007_s00417_023_06236_5 crossref_primary_10_1186_s40942_025_00637_w crossref_primary_10_1248_yakushi_20_00259 crossref_primary_10_3390_jcm10132871 crossref_primary_10_1016_j_ajo_2024_10_029 |
| Cites_doi | 10.1016/j.ophtha.2011.02.048 10.1056/NEJMoa1001288 10.1016/0021-9681(87)90171-8 10.1042/CS20120588 10.2337/dc13-2289 10.1016/j.diabet.2018.03.004 10.1016/j.diabres.2015.05.025 10.1001/archopht.119.5.709 10.1001/jamaophthalmol.2016.1669 10.4093/dmj.2016.40.5.339 10.1097/IAE.0000000000001098 10.1371/journal.pone.0167853 10.1111/dme.13384 10.3389/fphar.2017.00835 10.1155/2016/1423191 10.1016/j.ajo.2017.12.007 10.4093/dmj.2018.0047 10.1038/srep29393 10.4239/wjd.v7.i16.333 10.1001/jamaophthalmol.2017.0821 10.1155/2017/5164292 10.1007/s00125-017-4388-y 10.1161/ATVBAHA.109.198465 10.2337/dc17-2285 10.1016/j.amjcard.2012.04.061 10.4093/dmj.2018.42.2.93 10.4093/dmj.2018.0182 10.1186/s12933-018-0668-1 10.1016/j.ophtha.2014.08.048 10.1093/aje/kwp432 10.1136/bjophthalmol-2013-303168 10.1007/s00592-012-0449-3 10.2337/dc14-0865 10.1016/j.bbadis.2014.04.013 10.1097/MD.0000000000004018 |
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| Keywords | Diabetes mellitus, type 2 Diabetic retinopathy Dipeptidyl-peptidase IV inhibitors |
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| Snippet | To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy (DR) in... Background To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy... Background: To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progressionof diabetic retinopathy... |
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| SubjectTerms | Age Antidiabetics Blood pressure Cardiac arrhythmia Cholesterol Codes Cohort analysis Comorbidity Diabetes Diabetic retinopathy Glaucoma Glucose Hypertension Investigations Kidney diseases Medical screening Metabolic disorders Original Pilot projects Population Visual impairment 내과학 |
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| Title | Dipeptidyl Peptidase-4 Inhibitors versus Other Antidiabetic Drugs Added to Metformin Monotherapy in Diabetic Retinopathy Progression: A Real World-Based Cohort Study |
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