Clinical Practice Research Datalink, London, UK.
Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
Diabetes Obes Metab. 2017 Oct;19(10):1473-1478. doi: 10.1111/dom.12951. Epub 2017 Aug 3.
The aim of this non-interventional, multi-database, analytical cohort study was to assess the cardiovascular (CV) safety of vildagliptin vs other non-insulin antidiabetic drugs (NIADs) using real-world data from 5 European electronic healthcare databases. Patients with type 2 diabetes aged ≥18 years on NIAD treatment were enrolled. Adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the outcomes of interest (myocardial infarction [MI], acute coronary syndrome [ACS], stroke, congestive heart failure [CHF], individually and as a composite) were estimated using negative binomial regression. Approximately 2.8% of the enrolled patients (n = 738 054) used vildagliptin at any time during the study, with an average follow-up time of 1.4 years, resulting in a cumulative current vildagliptin exposure of 28 330 person-years. The adjusted IRRs (vildagliptin [±other NIADs] vs other NIADs) were in the range of 0.61 to 0.97 (MI), 0.55 to 1.60 (ACS), 0.02 to 0.77 (stroke), 0.49 to 1.03 (CHF), and 0.22 to 1.02 (composite CV outcomes). The IRRs and their 95% CIs were close to 1, demonstrating no increased risk of adverse CV events, including the risk of CHF, with vildagliptin vs other NIADs in real-world conditions.
本非干预性、多数据库、分析性队列研究旨在使用来自 5 个欧洲电子医疗保健数据库的真实世界数据,评估维格列汀与其他非胰岛素类降糖药(NIADs)相比的心血管(CV)安全性。研究纳入了正在接受 NIAD 治疗的年龄≥18 岁的 2 型糖尿病患者。使用负二项回归估计了感兴趣结局(心肌梗死 [MI]、急性冠脉综合征 [ACS]、卒中、充血性心力衰竭 [CHF],单独和作为复合结局)的校正发病率比值比(IRR)和 95%置信区间(CI)。研究期间,约 2.8%(n=738054)的入组患者曾使用过维格列汀,平均随访时间为 1.4 年,累积当前维格列汀暴露量为 28330 人年。调整后的 IRR(维格列汀[±其他 NIADs]与其他 NIADs)范围为 0.61 至 0.97(MI)、0.55 至 1.60(ACS)、0.02 至 0.77(卒中)、0.49 至 1.03(CHF)和 0.22 至 1.02(复合 CV 结局)。IRR 及其 95%CI 接近 1,表明在真实情况下,维格列汀与其他 NIADs 相比,CV 不良事件(包括 CHF 风险)的发生风险没有增加。