Comparing the effectiveness and cost-effectiveness of sulfonylureas and newer diabetes drugs as second-line therapy for patients with type 2 diabetes
Authors' conclusion
Newer diabetes drugs are more effective and cost-effective second-line options for the treatment of type 2 diabetes than SUs.
Study context
- Population
- Residents of Lombardy aged ≥40 years treated with metformin in 2014 who started second-line treatment 2015–2018; followed up until December 31, 20221,208 per group matched
- Participants
- 22,867 residents
- Exposure
- DPP-4i, SGLT2i and GLP-1 RA vs sulfonylureas and glinides (SU) as second-line therapy
- SUn = 10,577reference
- DPP-4in = 8,125
- SGLT2in = 2,893
- GLP-1-RAn = 1,272
- Outcome
- Hospitalization for MACE (risk reduction vs SU)
Methodological detailslinked regional healthcare utilization databases, matched for sex, age, Multisource Comorbidity Score and previous duration of metformin treatment, Cox proportional hazards models, cost-effectiveness analysis (ICER)
- Linked regional healthcare utilization databases
- Matched for sex, age, Multisource Comorbidity Score and previous duration of metformin treatment
- Cox proportional hazards models
- Cost-effectiveness analysis (ICER)
Main finding
As reported in the abstract
Risk reduction
22%
95% CI 3%–37%
DPP-4i
Risk reduction
29%
95% CI 12%–44%
SGLT2i
Risk reduction
41%
95% CI 26%–53%
GLP-1-RA
Observational data: associations, not effects.
Further findings
ICER: average gain per month free from major adverse cardiovascular events (MACE) vs SU
- DPP-4i
- €96.2
- SGLT2i
- €75.7
Original publication
Comparing the effectiveness and cost-effectiveness of sulfonylureas and newer diabetes drugs as second-line therapy for patients with type 2 diabetes. BMJ Open Diabetes Res Care. Published 27 May 2024. doi:10.
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