{"title":"Glucagon-like peptide-1 receptor agonists and risk of sight-threatening retinopathy in Taiwanese population: A propensity based cohort study","authors":"","doi":"10.1016/j.dsx.2024.103099","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><p>To compare the risk of vision-threatening retinopathy between glucagon-like peptide-1 receptor agonists (GLP-1 RA) use and no use in patients with type 2 diabetes.</p></div><div><h3>Methods</h3><p>Using propensity score matching, we identified 27,506 pairs of GLP-1 RA users and non-users, 3904 pairs of GLP-1 RA and dipeptidyl peptidase-4 inhibitors (DPP-4i) users, 10,985 pairs of GLP-1 RA and sodium-glucose cotransporter-2 inhibitors (SGLT2i) users, 2542 pairs of GLP-1 RA and sulfonylurea, respectively, from Taiwan's National Health Insurance Research Database from January 1, 2009 to December 31, 2018. We used Cox proportional hazards models to compare the risk of vision-threatening retinopathy between GLP-1 RA use and other matched groups.</p></div><div><h3>Results</h3><p>In the matched cohorts, the time-varying exposure analysis showed that GLP-1 RA use was not associated with an increased risk of vision-threatening retinopathy compared to GLP-1 RA non-use (aHR 0.96, 95 % CI 0.89–1.03). New-user and active-comparator analyses showed that GLP-1 RA was associated with a significantly lower risk of vision-threatening retinopathy than DPP-4i (aHR 0.8, 95 % CI 0.66–0.97) but had no significant association with this risk compared to SGLT2i (aHR 1.09, 95 % CI 0.96–1.24) or sulfonylureas (aHR 0.79, 95 % CI 0.49–1.06).</p></div><div><h3>Conclusions</h3><p>This nationwide cohort study showed that GLP-1 RA use was not associated with an increased risk of vision-threatening retinopathy compared to non- GLP-1 RA use, and GLP-1 RA could significantly lower the risk of vision-threatening retinopathy than DPP-4i.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1871402124001607","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Aims
To compare the risk of vision-threatening retinopathy between glucagon-like peptide-1 receptor agonists (GLP-1 RA) use and no use in patients with type 2 diabetes.
Methods
Using propensity score matching, we identified 27,506 pairs of GLP-1 RA users and non-users, 3904 pairs of GLP-1 RA and dipeptidyl peptidase-4 inhibitors (DPP-4i) users, 10,985 pairs of GLP-1 RA and sodium-glucose cotransporter-2 inhibitors (SGLT2i) users, 2542 pairs of GLP-1 RA and sulfonylurea, respectively, from Taiwan's National Health Insurance Research Database from January 1, 2009 to December 31, 2018. We used Cox proportional hazards models to compare the risk of vision-threatening retinopathy between GLP-1 RA use and other matched groups.
Results
In the matched cohorts, the time-varying exposure analysis showed that GLP-1 RA use was not associated with an increased risk of vision-threatening retinopathy compared to GLP-1 RA non-use (aHR 0.96, 95 % CI 0.89–1.03). New-user and active-comparator analyses showed that GLP-1 RA was associated with a significantly lower risk of vision-threatening retinopathy than DPP-4i (aHR 0.8, 95 % CI 0.66–0.97) but had no significant association with this risk compared to SGLT2i (aHR 1.09, 95 % CI 0.96–1.24) or sulfonylureas (aHR 0.79, 95 % CI 0.49–1.06).
Conclusions
This nationwide cohort study showed that GLP-1 RA use was not associated with an increased risk of vision-threatening retinopathy compared to non- GLP-1 RA use, and GLP-1 RA could significantly lower the risk of vision-threatening retinopathy than DPP-4i.
目的:比较2型糖尿病患者使用和不使用胰高血糖素样肽-1受体激动剂(GLP-1 RA)发生视力威胁性视网膜病变的风险:使用倾向得分匹配法,我们从2009年1月1日至2018年12月31日的台湾国民健康保险研究数据库中分别识别出27506对GLP-1 RA使用者和非使用者、3904对GLP-1 RA和二肽基肽酶-4抑制剂(DPP-4i)使用者、10985对GLP-1 RA和钠-葡萄糖共转运体-2抑制剂(SGLT2i)使用者、2542对GLP-1 RA和磺脲类药物使用者。我们使用Cox比例危险模型比较了使用GLP-1 RA和其他匹配组之间发生威胁视力的视网膜病变的风险:在匹配队列中,时变暴露分析表明,与不使用 GLP-1 RA 相比,使用 GLP-1 RA 与视力威胁性视网膜病变风险增加无关(aHR 0.96,95 % CI 0.89-1.03)。新用户和活跃比较者分析表明,与DPP-4i相比,GLP-1 RA与威胁视力的视网膜病变风险显著降低(aHR 0.8,95 % CI 0.66-0.97),但与SGLT2i(aHR 1.09,95 % CI 0.96-1.24)或磺脲类药物(aHR 0.79,95 % CI 0.49-1.06)相比,GLP-1 RA与该风险无显著关联:这项全国性队列研究表明,与不使用 GLP-1 RA 的患者相比,使用 GLP-1 RA 与视力威胁性视网膜病变风险的增加无关,而且 GLP-1 RA 比 DPP-4i 能显著降低视力威胁性视网膜病变的风险。
期刊介绍:
Diabetes and Metabolic Syndrome: Clinical Research and Reviews is the official journal of DiabetesIndia. It aims to provide a global platform for healthcare professionals, diabetes educators, and other stakeholders to submit their research on diabetes care.
Types of Publications:
Diabetes and Metabolic Syndrome: Clinical Research and Reviews publishes peer-reviewed original articles, reviews, short communications, case reports, letters to the Editor, and expert comments. Reviews and mini-reviews are particularly welcomed for areas within endocrinology undergoing rapid changes.