J Bradley Layton, Ryan Ziemiecki, Catherine B Johannes, Manel Pladevall-Vila, Anam M Khan, Natalie Ebert, Csaba P Kovesdy, Christian Fynbo Christiansen, Aníbal García-Sempere, Hiroshi Kanegae, Craig I Coleman, Michael Walsh, Ina Trolle Andersen, Clara Rodríguez-Bernal, Celia Robles Cabaniñas, Reimar W Thomsen, Alfredo E Farjat, Alain Gay, Patrick Gee, Isabel Hurtado, Naoki Kashihara, Philip Vestergaard Munch, Fangfang Liu, Suguru Okami, Satoshi Yamashita, Yuichiro Yano, David Vizcaya, Nikolaus G Oberprieler
{"title":"2型糖尿病和慢性肾病患者使用SGLT2抑制剂或GLP-1受体激动剂的新用户队列的结局","authors":"J Bradley Layton, Ryan Ziemiecki, Catherine B Johannes, Manel Pladevall-Vila, Anam M Khan, Natalie Ebert, Csaba P Kovesdy, Christian Fynbo Christiansen, Aníbal García-Sempere, Hiroshi Kanegae, Craig I Coleman, Michael Walsh, Ina Trolle Andersen, Clara Rodríguez-Bernal, Celia Robles Cabaniñas, Reimar W Thomsen, Alfredo E Farjat, Alain Gay, Patrick Gee, Isabel Hurtado, Naoki Kashihara, Philip Vestergaard Munch, Fangfang Liu, Suguru Okami, Satoshi Yamashita, Yuichiro Yano, David Vizcaya, Nikolaus G Oberprieler","doi":"10.1007/s13300-025-01750-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>People with chronic kidney disease (CKD) and type 2 diabetes (T2D) have an increased risk of kidney failure and cardiovascular disease. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) have shown cardiorenal protective effects. The objective of this multinational, multidatabase study was to describe the incidence of kidney and cardiovascular outcomes in separate, non-mutually exclusive cohorts of patients with CKD and T2D who initiated either an SGLT2i or a GLP-1 RA.</p><p><strong>Methods: </strong>Data describing adults (≥ 18 years) with T2D and CKD who were new users of either SGLT2i or GLP-1 RA from 2012 to 2019 were assessed from population-based Danish National Health Registers (DNHR) and Valencia Health System Integrated Database (VID), hospital-based Japan Chronic Kidney Disease Database Extension (J-CKD-DB-Ex), and US Optum<sup>®</sup> de-identified Electronic Health Record dataset (Optum<sup>®</sup> EHR). Crude incidence rates (IRs) and 95% confidence intervals (CIs) for primary outcomes (kidney failure, acute coronary syndrome, stroke, new-onset congestive heart failure, new-onset atrial fibrillation) and cumulative incidence by follow-up time for primary and secondary outcomes (laboratory measurements of kidney function) were estimated.</p><p><strong>Results: </strong>SGLT2i cohorts comprised 12,501 patients in DNHR, 22,404 in VID, 811 in J-CKD-DB-Ex, and 54,308 in Optum<sup>®</sup> EHR. GLP-1 RA cohorts comprised 10,696 in DNHR, 8317 in VID, 219 in J-CKD-DB-Ex, and 78,934 in Optum<sup>®</sup> EHR. Baseline clinical profile differences were observed for GLP-1 RA and SGLT2i new users, and crude IRs of kidney and heart failure tended to be higher in the GLP-1 RA cohorts than in the SGLT2i cohorts across data sources.</p><p><strong>Conclusion: </strong>Understanding the incidence of kidney failure and cardiovascular outcomes in people receiving antidiabetic medications with cardiorenal protective effects is important for future studies aiming to compare the incidence of kidney and cardiovascular outcomes related to new and existing CKD treatments.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes in New User Cohorts of SGLT2 Inhibitors or GLP-1 Receptor Agonists with Type 2 Diabetes and Chronic Kidney Disease.\",\"authors\":\"J Bradley Layton, Ryan Ziemiecki, Catherine B Johannes, Manel Pladevall-Vila, Anam M Khan, Natalie Ebert, Csaba P Kovesdy, Christian Fynbo Christiansen, Aníbal García-Sempere, Hiroshi Kanegae, Craig I Coleman, Michael Walsh, Ina Trolle Andersen, Clara Rodríguez-Bernal, Celia Robles Cabaniñas, Reimar W Thomsen, Alfredo E Farjat, Alain Gay, Patrick Gee, Isabel Hurtado, Naoki Kashihara, Philip Vestergaard Munch, Fangfang Liu, Suguru Okami, Satoshi Yamashita, Yuichiro Yano, David Vizcaya, Nikolaus G Oberprieler\",\"doi\":\"10.1007/s13300-025-01750-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>People with chronic kidney disease (CKD) and type 2 diabetes (T2D) have an increased risk of kidney failure and cardiovascular disease. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) have shown cardiorenal protective effects. The objective of this multinational, multidatabase study was to describe the incidence of kidney and cardiovascular outcomes in separate, non-mutually exclusive cohorts of patients with CKD and T2D who initiated either an SGLT2i or a GLP-1 RA.</p><p><strong>Methods: </strong>Data describing adults (≥ 18 years) with T2D and CKD who were new users of either SGLT2i or GLP-1 RA from 2012 to 2019 were assessed from population-based Danish National Health Registers (DNHR) and Valencia Health System Integrated Database (VID), hospital-based Japan Chronic Kidney Disease Database Extension (J-CKD-DB-Ex), and US Optum<sup>®</sup> de-identified Electronic Health Record dataset (Optum<sup>®</sup> EHR). Crude incidence rates (IRs) and 95% confidence intervals (CIs) for primary outcomes (kidney failure, acute coronary syndrome, stroke, new-onset congestive heart failure, new-onset atrial fibrillation) and cumulative incidence by follow-up time for primary and secondary outcomes (laboratory measurements of kidney function) were estimated.</p><p><strong>Results: </strong>SGLT2i cohorts comprised 12,501 patients in DNHR, 22,404 in VID, 811 in J-CKD-DB-Ex, and 54,308 in Optum<sup>®</sup> EHR. GLP-1 RA cohorts comprised 10,696 in DNHR, 8317 in VID, 219 in J-CKD-DB-Ex, and 78,934 in Optum<sup>®</sup> EHR. Baseline clinical profile differences were observed for GLP-1 RA and SGLT2i new users, and crude IRs of kidney and heart failure tended to be higher in the GLP-1 RA cohorts than in the SGLT2i cohorts across data sources.</p><p><strong>Conclusion: </strong>Understanding the incidence of kidney failure and cardiovascular outcomes in people receiving antidiabetic medications with cardiorenal protective effects is important for future studies aiming to compare the incidence of kidney and cardiovascular outcomes related to new and existing CKD treatments.</p>\",\"PeriodicalId\":11192,\"journal\":{\"name\":\"Diabetes Therapy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s13300-025-01750-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13300-025-01750-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Outcomes in New User Cohorts of SGLT2 Inhibitors or GLP-1 Receptor Agonists with Type 2 Diabetes and Chronic Kidney Disease.
Introduction: People with chronic kidney disease (CKD) and type 2 diabetes (T2D) have an increased risk of kidney failure and cardiovascular disease. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) have shown cardiorenal protective effects. The objective of this multinational, multidatabase study was to describe the incidence of kidney and cardiovascular outcomes in separate, non-mutually exclusive cohorts of patients with CKD and T2D who initiated either an SGLT2i or a GLP-1 RA.
Methods: Data describing adults (≥ 18 years) with T2D and CKD who were new users of either SGLT2i or GLP-1 RA from 2012 to 2019 were assessed from population-based Danish National Health Registers (DNHR) and Valencia Health System Integrated Database (VID), hospital-based Japan Chronic Kidney Disease Database Extension (J-CKD-DB-Ex), and US Optum® de-identified Electronic Health Record dataset (Optum® EHR). Crude incidence rates (IRs) and 95% confidence intervals (CIs) for primary outcomes (kidney failure, acute coronary syndrome, stroke, new-onset congestive heart failure, new-onset atrial fibrillation) and cumulative incidence by follow-up time for primary and secondary outcomes (laboratory measurements of kidney function) were estimated.
Results: SGLT2i cohorts comprised 12,501 patients in DNHR, 22,404 in VID, 811 in J-CKD-DB-Ex, and 54,308 in Optum® EHR. GLP-1 RA cohorts comprised 10,696 in DNHR, 8317 in VID, 219 in J-CKD-DB-Ex, and 78,934 in Optum® EHR. Baseline clinical profile differences were observed for GLP-1 RA and SGLT2i new users, and crude IRs of kidney and heart failure tended to be higher in the GLP-1 RA cohorts than in the SGLT2i cohorts across data sources.
Conclusion: Understanding the incidence of kidney failure and cardiovascular outcomes in people receiving antidiabetic medications with cardiorenal protective effects is important for future studies aiming to compare the incidence of kidney and cardiovascular outcomes related to new and existing CKD treatments.
期刊介绍：
Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged.
The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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