PMID- 34992535
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220108
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 12
DP  - 2021
TI  - Comparison of Adverse Kidney Outcomes With Empagliflozin and Linagliptin Use in 
      Patients With Type 2 Diabetic Patients in a Real-World Setting.
PG  - 781379
LID - 10.3389/fphar.2021.781379 [doi]
LID - 781379
AB  - Background: To compare the effects of empagliflozin and linagliptin use on kidney 
      outcomes of type 2 diabetes mellitus (T2DM) patients in a real-world setting. 
      Methods: The study involved a propensity score-matched cohort comprising new 
      users of empagliflozin or linagliptin with T2DM between January 1, 2013 and 
      December 31, 2018 from a large healthcare delivery system in Taiwan. Clinical 
      outcomes assessed: acute kidney injury (AKI), post-AKI dialysis, and mortality. 
      Cox proportional hazard model was used to estimate the relative risk of 
      empagliflozin or linagliptin use; a linear mixed model was used to compare the 
      average change in estimated glomerular filtration rate (eGFR) over time. Results: 
      Of the 7,042 individuals, 67 of 3,521 (1.9%) in the empagliflozin group and 144 
      of 3,521 (4.1%) in the linagliptin group developed AKI during the 2 years 
      follow-up. Patients in the empagliflozin group were at a 40% lower risk of 
      developing AKI compared to those in the linagliptin group (adjusted hazard ratio 
      [aHR], 0.60; 95% confidence interval [CI], 0.45-0.82, p = 0.001). Stratified 
      analysis showed that empagliflozin users >/=65 years of age (aHR, 0.70; 95% CI, 
      0.43-1.13, p = 0.148), or with a baseline eGFR <60 ml/min/1.73 m(2) (aHR, 0.97; 
      95% CI, 0.57-1.65, p = 0.899), or with a baseline glycohemoglobin <==7% (aHR, 1.01; 
      95% CI, 0.51-2.00, p =0.973) experienced attenuated benefits with respect to AKI 
      risk. A smaller decline in eGFR was observed in empagliflozin users compared to 
      linagliptin users regardless of AKI occurrence (adjusted beta = 1.51; 95% CI, 
      0.30-2.72 ml/min/1.73 m(2), p = 0.014). Conclusion: Empagliflozin users were at a 
      lower risk of developing AKI and exhibited a smaller eGFR decline than 
      linagliptin users. Thus, empagliflozin may be a safer alternative to linagliptin 
      for T2DM patients.
CI  - Copyright (c) 2021 Lee, Hsu, Fu, Wang, Huang and Li.
FAU - Lee, Yueh-Ting
AU  - Lee YT
AD  - Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung 
      Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 
      Taiwan.
FAU - Hsu, Chien-Ning
AU  - Hsu CN
AD  - Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung, Taiwan.
AD  - School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
FAU - Fu, Chung-Ming
AU  - Fu CM
AD  - Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung 
      Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 
      Taiwan.
FAU - Wang, Shih-Wei
AU  - Wang SW
AD  - Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung, Taiwan.
FAU - Huang, Chiang-Chi
AU  - Huang CC
AD  - Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung 
      Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 
      Taiwan.
FAU - Li, Lung-Chih
AU  - Li LC
AD  - Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung 
      Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 
      Taiwan.
AD  - Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung 
      Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 
      Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20211221
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC8724779
OTO - NOTNLM
OT  - SGLT2 inhibitor
OT  - acute kidney injury
OT  - empaglifiozin
OT  - linagliptin
OT  - type 2 diabetes
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/01/08 06:00
MHDA- 2022/01/08 06:01
PMCR- 2021/12/21
CRDT- 2022/01/07 06:22
PHST- 2021/09/22 00:00 [received]
PHST- 2021/12/02 00:00 [accepted]
PHST- 2022/01/07 06:22 [entrez]
PHST- 2022/01/08 06:00 [pubmed]
PHST- 2022/01/08 06:01 [medline]
PHST- 2021/12/21 00:00 [pmc-release]
AID - 781379 [pii]
AID - 10.3389/fphar.2021.781379 [doi]
PST - epublish
SO  - Front Pharmacol. 2021 Dec 21;12:781379. doi: 10.3389/fphar.2021.781379. 
      eCollection 2021.