Intraclass differences in the risk of hospitalization for heart failure among patients with type 2 diabetes initiating a dipeptidyl peptidase‐4 inhibitor or a sulphonylurea: <scp>R</scp> esults from the <scp>OsMed H</scp> ealth‐ <scp>DB</scp> registry

Abstract

Aims To re‐analyse data from a previous retrospective study on 127 555 patients, in which we showed that dipeptidyl peptidase‐4 ( DPP ‐4) inhibitor therapy was associated with a lower risk of hospitalization for HF ( HHF ) than sulphonylurea ( SU ) therapy, in order to evaluate intraclass differences among DPP ‐4 inhibitors and SUs . Methods We included patients with type 2 diabetes ( T2D ) initiating DPP ‐4 inhibitor or SU therapy, alone or in combination with metformin. Patients undergoing intraclass switch, those with a previous HHF , those receiving insulin treatment, and those with &lt;6 months observation were excluded. We calculated the incidence of first and total HHF events/1000 person‐years. Cox proportional hazard and Poisson multiple regression models, as well as propensity‐score matching, were used to account for baseline confounders. Results The analysis included 17 615 DPP ‐4 inhibitor users (60.1% sitagliptin; 27.0% vildagliptin; 12.9% saxagliptin) and 86 734 SU users (37.5% glibenclamide; 34.6% glimepiride; 27.9% gliclazide). No intraclass difference in the incidence rate of first and total HHF events was noted among the 3 DPP ‐4 inhibitors or among the 3 SUs . Multivariable adjustments for baseline confounders or propensity‐score matching did not change the results. In addition, no intraclass difference in HHF risk was observed in patients at high compared with low cardiovascular risk. Conclusions In a cohort of patients with T2D taken from approximately one‐third of the Italian population, no intraclass difference was noted for DPP ‐4 inhibitor and SU therapy with regard to HHF risk.