Long‐term outcomes following alternative second‐line oral glucose‐lowering treatments: Results from the real‐world progression in type 2 diabetes mellitus United Kingdom ( RAPIDS ‐ UK ) model
Authors' conclusion
For a general T2DM population, second-line treatment with SGLT2i rather than SU or DPP4i can reduce the probability of complications within 5 years.
Study context
- Population
- People with T2D starting second-line oral glucose-lowering treatment in routine practice, England
- Comparison
- Second-line SGLT2i vs sulphonylureas (SU) vs DPP-4i added to metformin
- Outcome
- Predicted probabilities of end-stage kidney disease (ESKD), HF hospitalisation, diabetic eye disease, myocardial infarction (MI) and lower-extremity amputation
- Follow-up
- 5 years after second-line treatment initiation
Methodological detailsRAPIDS microsimulation model, real-world treatment duration from Clinical Practice Research Datalink (England), treatment effectiveness from Randomised Controlled Trials (RCTs)
- RAPIDS microsimulation model
- Real-world treatment duration from Clinical Practice Research Datalink (England)
- Treatment effectiveness from RCTs
Main finding
As reported in the abstract
Predicted probability of ESKD · 5 years
Mean difference, % (95% CI)
SGLT2ivs SU
−0.81(−0.89 to −0.73)
SGLT2ivs DPP4i
−0.87(−0.95 to −0.79)
Further findings
| Outcome | Difference (%) (CI) | |
|---|---|---|
| Predicted probability of HF hospitalisation · 5 yearsSGLT2ivs SUReduction with SGLT2i | −0.90 (−1.01 to −0.80) | |
| Predicted probability of HF hospitalisation · 5 yearsSGLT2ivs DPP4iReduction with SGLT2i | −0.95 (−1.06 to −0.84) | |
| Predicted probability of diabetic eye disease · 5 yearsSGLT2ivs SU | −1.41 (−1.57 to −1.26) | |
| Predicted probability of diabetic eye disease · 5 yearsSGLT2ivs DPP4i | −0.44 (−0.59 to −0.29) | |
| −2−101Difference, % (linear scale) |
Predicted probability of lower-extremity amputation · 5 years
- Predicted probabilities of lower-extremity amputation (LEA) similar across treatments
Effect modification by pre-existing CVD
- Pre-existing CVD did not modify predicted probabilities of complications
Original publication
Long‐term outcomes following alternative second‐line oral glucose‐lowering treatments: Results from the real‐world progression in type 2 diabetes mellitus United Kingdom ( RAPIDS ‐ UK ) model. Diabetes Obes Metab. Published 21 May 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →