TY - JOUR
T1 - Dipeptidyl peptidase-4 inhibitor use and risk of diabetic retinopathy
T2 - A population-based study
AU - Kim, N. H.
AU - Choi, J.
AU - Choi, K. M.
AU - Baik, S. H.
AU - Lee, J.
AU - Kim, S. G.
N1 - Funding Information:
This study was partly supported by a grant of the Korean Health Technology R&D Project (HI14C2750), Ministry of Health & Welfare, Republic of Korea.
Publisher Copyright:
© 2018 Elsevier Masson SAS
PY - 2018/9
Y1 - 2018/9
N2 - Aims: This study examined whether dipeptidyl peptidase (DPP)-4 inhibitor use is beneficial or harmful to diabetic retinopathy (DR) compared with other glucose-lowering agents in patients with type 2 diabetes (T2D). Methods: From a population-based cohort provided by the National Health Insurance Service in Korea, 67,743 adults with T2D were identified as having been treated with oral glucose-lowering agents between 2008 and 2013. Matching (1:1) was performed for two groups comparing ever-use (cases) and never-use (controls) of DPP-4 inhibitors (n = 14,522 in each group). Cox regression analyses were used to assess risk of the following DR events: vitreous haemorrhage; vitrectomy or photocoagulation; intravitreal agent use; and blindness. Results: During a median follow-up of 28.4 (14.0–45.2) months, there were 305 (in controls) and 342 (in cases) composite DR events. DPP-4 inhibitor ever-use was not associated with overall risk of composite DR events [adjusted hazard ratio (HR): 1.08, 95% CI: 0.93–1.26] compared with never-use, nor was the risk of each DR outcome increased with DPP-4 inhibitor therapy either. However, DPP-4 inhibitor administration for < 12 months was associated with a greater risk of composite DR events (adjusted HR: 1.31, 95% CI: 1.09–1.57) compared with other glucose-lowering agents over the same treatment period. Conclusion: In comparison to other oral glucose-lowering agents, DPP-4 inhibitor treatment did not increase overall risk of DR. However, DPP-4 inhibitors may be associated with an increased risk of retinopathy events early in the treatment phase.
AB - Aims: This study examined whether dipeptidyl peptidase (DPP)-4 inhibitor use is beneficial or harmful to diabetic retinopathy (DR) compared with other glucose-lowering agents in patients with type 2 diabetes (T2D). Methods: From a population-based cohort provided by the National Health Insurance Service in Korea, 67,743 adults with T2D were identified as having been treated with oral glucose-lowering agents between 2008 and 2013. Matching (1:1) was performed for two groups comparing ever-use (cases) and never-use (controls) of DPP-4 inhibitors (n = 14,522 in each group). Cox regression analyses were used to assess risk of the following DR events: vitreous haemorrhage; vitrectomy or photocoagulation; intravitreal agent use; and blindness. Results: During a median follow-up of 28.4 (14.0–45.2) months, there were 305 (in controls) and 342 (in cases) composite DR events. DPP-4 inhibitor ever-use was not associated with overall risk of composite DR events [adjusted hazard ratio (HR): 1.08, 95% CI: 0.93–1.26] compared with never-use, nor was the risk of each DR outcome increased with DPP-4 inhibitor therapy either. However, DPP-4 inhibitor administration for < 12 months was associated with a greater risk of composite DR events (adjusted HR: 1.31, 95% CI: 1.09–1.57) compared with other glucose-lowering agents over the same treatment period. Conclusion: In comparison to other oral glucose-lowering agents, DPP-4 inhibitor treatment did not increase overall risk of DR. However, DPP-4 inhibitors may be associated with an increased risk of retinopathy events early in the treatment phase.
KW - Diabetic retinopathy
KW - Dipeptidyl peptidase-4 inhibitors
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85046660016&partnerID=8YFLogxK
U2 - 10.1016/j.diabet.2018.03.004
DO - 10.1016/j.diabet.2018.03.004
M3 - Article
C2 - 29752167
AN - SCOPUS:85046660016
SN - 1262-3636
VL - 44
SP - 361
EP - 367
JO - Diabetes and Metabolism
JF - Diabetes and Metabolism
IS - 4
ER -
