Superior benefits of sodium‐glucose co‐transporter‐2 inhibitors compared with dipeptidyl peptidase‐4 inhibitors for diabetic kidney disease: A cohort study
Authors' conclusion
This study shows the superior cardiorenal benefits of SGLT-2is compared with DPP-4is in the DKD population, regardless of concomitant antidiabetic agents or time from DKD onset to study drug initiation. SGLT-2is should be prioritized in adult patients with DKD.
Study context
- Population
- Adults with diabetic kidney disease (DKD) and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2, new users 2017–2018, Taiwan's National Health Insurance Research Database and Laboratory Databasespropensity score-matched
- Participants
- 1,524 vs 6,005
- Exposure
- SGLT2i vs DPP-4i
- SGLT-2isn = 1,524
- DPP-4isn = 6,005reference
- Outcome
- Composite renal outcome (sustained eGFR decrease, renal failure, renal mortality) and composite cardiovascular (CV) outcome (acute MI, stroke, hospitalization for HF, CV death)
Methodological detailspropensity score-matched, prevalent new users, national database
- Propensity score-matched
- Prevalent new users
- National database
Main finding
As reported in the abstract
Composite renal endpoint
Each group vs DPP-4isEstimate (CI)
SGLT-2is
HR 0.16(0.12–0.24)
SGLT-2is
HR (composite CV outcome) 0.74(0.64–0.85)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| 50% or higher eGFR decrease | 0.17 (0.11–0.27) | |
| Renal failure | 0.14 (0.08–0.23) | |
| Renal death | 0.10 (0.01–0.70) | |
| Stroke | 0.76 (0.62–0.92) | |
| Hospitalization for HF | 0.68 (0.55–0.84) | |
| 0.050.21520Hazard ratio (log scale) |
Stratified analyses
- Findings consistent when stratified by concomitant antidiabetic agents or interval between DKD diagnosis and study drug initiation
Original publication
Superior benefits of sodium‐glucose co‐transporter‐2 inhibitors compared with dipeptidyl peptidase‐4 inhibitors for diabetic kidney disease: A cohort study. Diabetes Obes Metab. Published 18 October 2024. doi:10.
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