GLP-1RA vs DPP-4i Use and Rates of Hyperkalemia and RAS Blockade Discontinuation in Type 2 Diabetes
An erratum to this article was published (JAMA Intern Med, 1 Mar 2025 ↗)
Authors' conclusion
In this study of patients with T2D managed in routine clinical care, the use of GLP-1RAs was associated with lower rates of hyperkalemia and sustained RASi use compared with DPP-4i use. These findings suggest that GLP-1RA treatment may enable wider use of guideline-recommended medications and contribute to clinical outcomes in this population.
Study context
- Population
- Adults with T2D in the region of Stockholm, Sweden, initiating GLP-1 RA or DPP-4i treatment between 2008 and 2021; mean age 63.7 years, 59.7% male
- Participants
- 33,280 adults
- Exposure
- GLP-1 RA vs DPP-4i
- GLP-1RAsn = 13,633
- DPP-4isn = 19,647reference
- Outcome
- Time to any hyperkalemia (potassium >5.0 mEq/L) and moderate to severe hyperkalemia (potassium >5.5 mEq/L)
Methodological detailsnew-user design, inverse probability of treatment weighting, marginal structural models, per-protocol, Median (IQR) time receiving treatment 3.9 (1.0-10.9) months
- New-user design
- Inverse probability of treatment weighting
- Marginal structural models
- Per-protocol
- Median (IQR) time receiving treatment 3.9 (1.0-10.9) months
Main finding
As reported in the abstract
Hyperkalemia
GLP-1RAs vs DPP-4isHazard ratio (95% CI)
Any hyperkalemia
0.61(0.50–0.76)
Moderate to severe hyperkalemia
0.52(0.28–0.84)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| RASi discontinuation among RASi users at baseline | 0.89 (0.82–0.97) | |
| 0.512Hazard ratio (log scale) |
- RASi discontinuation among RASi users at baseline — RASi users who discontinued therapy
- 1381 of 21 751
Original publication
GLP-1RA vs DPP-4i Use and Rates of Hyperkalemia and RAS Blockade Discontinuation in Type 2 Diabetes. JAMA Intern Med. Published 1 October 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →