Abstract
Objectives: To establish whether these benefits can be replicated in a real-world setting, should be expected with the use of dapagliflozin, and apply to T2DM patients at low risk of CVD.
Design: General Practice, population-based, retrospective cohort study (January 2013-September 2015).
Setting: The Health Improvement Network Database (THIN).
Participants: A total of 22,124 patients (4,444 exposed to dapagliflozin, 17,680 unexposed T2DM patients), matched for age, sex, body mass index, T2DM duration and smoking.
Main outcome measures: The primary outcome was all-cause mortality in the total study (high and low risk for CVD) population expressed as the adjusted incidence rate ratio (aIRR) with 95% confidence intervals (CI). As a secondary analysis in the low risk population, all-cause mortality and incident cardiovascular disease (CVD) were considered.
Results: Patients with T2DM exposed to dapagliflozin were significantly less likely to die from any cause (0.50, 95% CI: 0.33-0.75, p-value = 0.001). Similarly, in low risk patients, death from any cause was significantly lower in the exposed to dapagliflozin cohort (aIRR: 0.44, 95% CI: 0.25-0.78, p-value = 0.002). The difference in the risk of incident CVD did not reach statistical significance between groups in low-risk patients (aIRR: 0.89, 95% CI: 0.61-1.31, p-value = 0.546).
Conclusions: Patients with T2DM exposed to dapagliflozin were at a lower risk of death from any cause irrespective of baseline CVD status. In a population-based, open cohort study, patients with T2DM exposed to dapagliflozin were at a lower risk of death from any cause irrespective of their baseline CVD risk.
| Original language | English |
|---|---|
| Pages (from-to) | 1719-1725 |
| Number of pages | 7 |
| Journal | Journal of Clinical Endocrinology and Metabolism |
| Volume | 102 |
| Issue number | 5 |
| Early online date | 20 Feb 2017 |
| DOIs | |
| Publication status | Published - 1 May 2017 |
Access to Document
- Konstantinos_Toulis_et_al_All_cause_mortality_in_patients_with_diabetes_under_treatment_with_dapagliflozin_Journal_of_Clinical_Endocrinology_and_Metabolism_2017
Checked for eligibility: 30/03/2017 This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Clinical Endocrinology and Metabolism following peer review. The version of record Konstantinos A. Toulis, Brian H. Willis, Tom Marshall, Balachadran Kumarendran, Krishna Gokhale, Sandip Ghosh, G. Neil Thomas, Kar Keung Cheng, Parth Narendran, Wasim Hanif, Krishnarajah Nirantharakumar; All-Cause Mortality in Patients With Diabetes Under Treatment With Dapagliflozin: A Population-Based, Open-Cohort Study in The Health Improvement Network Database, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 5, 1 May 2017, Pages 1719–1725, is available online at: https://doi.org/10.1210/jc.2016-3446.