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. 2016 Sep;7(3):483-96.
doi: 10.1007/s13300-016-0177-8. Epub 2016 Jun 4.

Microvascular Outcomes in Patients with Type 2 Diabetes Treated with Vildagliptin vs. Sulfonylurea: A Retrospective Study Using German Electronic Medical Records

Wlodzimierz M Kolaczynski  1 , Matthew Hankins  2 , Siew H Ong  3 , Hartmut Richter  4 , Andreas Clemens  3 , Massoud Toussi  5
Affiliations

Microvascular Outcomes in Patients with Type 2 Diabetes Treated with Vildagliptin vs. Sulfonylurea: A Retrospective Study Using German Electronic Medical Records

Wlodzimierz M Kolaczynski et al. Diabetes Ther. 2016 Sep.

Abstract

Introduction: Preliminary data suggest that dipeptidyl peptidase-4 (DPP-4) inhibitors may reduce microvascular events, but there is a little evidence to support this from adequate real-world studies. This study aimed to compare microvascular outcomes between patients-prescribed vildagliptin and those prescribed sulfonylurea (SU).

Methods: This retrospective cohort study was conducted on a large sample from the German electronic medical records database IMS Lifelink Disease Analyzer. We used propensity score-matched samples of patients prescribed either vildagliptin or SU. Exposure was defined as therapy (SU or vildagliptin); primary outcomes were a diagnosis of retinopathy, nephropathy, neuropathy, or diabetic foot ulcer over the observation period in patients with no previous record of these outcomes. Secondary outcome was a composite of any primary outcome occurring in the observation period.

Results: In total, 16,321 patients prescribed SU and 4481 prescribed vildagliptin met the inclusion criteria. After propensity score matching, each sample comprised 3015 patients. Mean age was 63.7/64.6 years for SU/vildagliptin, respectively, with mean disease duration of 3.2/3.1 years, and mean treatment duration of 2.5/2.3 years. Treatment with vildagliptin was associated with a significant lower incidence of retinopathy [odds ratio (OR) = 0.55, P = 0.0004], neuropathy (OR 0.71, P = 0.0001), and composite outcome (OR 0.70, P < 0.0001). Incidences of nephropathy and diabetic foot ulcer were lower for vildagliptin, but not significantly so (OR 0.90, P = 0.3920; OR 0.76, P = 0.0742, respectively). There were no significant differences in incident rate ratios (all P > 0.05).

Conclusion: Treatment with vildagliptin was associated with a reduced incidence of microvascular complications, especially neuropathy and retinopathy, compared to treatment with SU in this clinical practice setting.

Funding: Novartis Pharma AG.

Keywords: DPP-4 inhibitors; Diabetes; Endocrinology; Microvascular complications; Real-world evidence; Vildagliptin.

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Figures

Fig. 1
Fig. 1
Distribution of propensity scores for vildagliptin and sulfonylurea samples
Fig. 2
Fig. 2
Odds ratio (95% confidence intervals) for the occurrence of microvascular events for vildagliptin vs. sulfonylurea (matched samples)
Fig. 3
Fig. 3
Incident rate ratios (95% confidence intervals) for vildagliptin vs. sulfonylurea (matched samples)
See this image and copyright information in PMC

References

    1. World Health Organization. WHO Fact sheet No. 312—diabetes. [article online]. 2014. http://www.who.int/mediacentre/factsheets/fs312/en/. Accessed 18 Dec 2014.
    1. International Diabetes Federation (IDF). The global burden. [article online]. 2014. http://www.idf.org/diabetesatlas/5e/the-globalburden. Accessed 18 Dec 2014.
    1. Organisation for Economic Co-operation and Development, Danish Diabetes Association, Novo Nordisk. The diabetes epidemic and its impact on Europe. Copenhagen: European Diabetes Leadership Forum. [article online]. 2012. http://www.oecd.org/els/health-systems/50080632.pdf. Accessed 18 Dec 2014.
    1. Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Diabetologia. 2012;55(6):1577–1596. doi: 10.1007/s00125-012-2534-0. - DOI - PubMed
    1. Pirart J. Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973 (3rd and last part) (author’s transl) Diabete Metab. 1977;3(4):245–256. - PubMed

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