{"id":23079,"date":"2022-12-11T05:08:00","date_gmt":"2022-12-10T21:08:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=23079"},"modified":"2022-12-11T07:34:57","modified_gmt":"2022-12-10T23:34:57","slug":"bmj%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a2%e5%9e%8b%e7%b3%96%e5%b0%bf%e7%97%85%e6%82%a3%e8%80%85%e4%bd%bf%e7%94%a8%e6%96%b0%e5%9e%8b%e9%99%8d%e8%a1%80%e7%b3%96%e8%8d%af%e7%89%a9%e4%b8%8eaecop","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=23079","title":{"rendered":"[BMJ\u53d1\u8868\u8bba\u6587]\uff1a2\u578b\u7cd6\u5c3f\u75c5\u60a3\u8005\u4f7f\u7528\u65b0\u578b\u964d\u8840\u7cd6\u836f\u7269\u4e0eAECOPD\u7684\u9884\u9632"},"content":{"rendered":"\n

Research<\/strong><\/p>\n\n\n\n

Novel antihyperglycaemic drugs and prevention of chronic obstructive pulmonary disease exacerbations among patients with type 2 diabetes: population based cohort study<\/h1>\n\n\n\n

Richeek Pradhan, Sally Lu, Hui Yin,\u00a0et al<\/h3>\n\n\n\n

BMJ<\/em>\u00a02022;\u00a0379\u00a0doi:\u00a0https:\/\/doi.org\/10.1136\/bmj-2022-071380<\/a>\u00a0(Published 01 November 2022)Cite this as:\u00a0BMJ<\/em>\u00a02022;379:e071380<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Objective<\/strong> To determine whether the use of glucagon-like peptide 1 (GLP-1) receptor agonists, dipeptidyl peptidase 4 (DPP-4) inhibitors, and sodium-glucose co-transporter-2 (SGLT-2) inhibitors, separately, is associated with a decreased risk of exacerbations of chronic obstructive pulmonary disease among patients with chronic obstructive pulmonary disease and type 2 diabetes.<\/p>\n\n\n\n

Design<\/strong> Population based cohort study using an active comparator, new user design.<\/p>\n\n\n\n

Setting<\/strong> The United Kingdom Clinical Practice Research Datalink linked with the Hospital Episode Statistics Admitted Patient Care and Office for National Statistics databases.<\/p>\n\n\n\n

Participants<\/strong> Three active comparator, new user cohorts of patients starting the study drugs (GLP-1 receptor agonists, DPP-4 inhibitors, or SGLT-2 inhibitors) or sulfonylureas with a history of chronic obstructive pulmonary disease. The first cohort included 1252 patients starting GLP-1 receptor agonists and 14\u2009259 starting sulfonylureas, the second cohort included 8731 patients starting DPP-4 inhibitors and 18\u2009204 starting sulfonylureas, and the third cohort included 2956 patients starting SGLT-2 inhibitors and 10\u2009841 starting sulfonylureas.<\/p>\n\n\n\n

Main outcome measures<\/strong> Cox proportional hazards models with propensity score fine stratification weighting were fitted to estimate hazard ratios and 95% confidence intervals of severe exacerbation of chronic obstructive pulmonary disease (defined as hospital admission for chronic obstructive pulmonary disease), separately for GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT-2 inhibitors. Whether these drugs were associated with a decreased risk of moderate exacerbation (defined as a co-prescription of an oral corticosteroid and an antibiotic along with an outpatient diagnosis of acute chronic obstructive pulmonary disease exacerbation on the same day) was also assessed.<\/p>\n\n\n\n

Results<\/strong> Compared with sulfonylureas, GLP-1 receptor agonists were associated with a 30% decreased risk of severe exacerbation (3.5 v<\/em> 5.0 events per 100 person years; hazard ratio 0.70, 95% confidence interval 0.49 to 0.99) and moderate exacerbation (0.63, 0.43 to 0.94). DPP-4 inhibitors were associated with a modestly decreased incidence of severe exacerbation (4.6 v<\/em>. 5.1 events per 100 person years; hazard ratio 0.91, 0.82 to 1.02) and moderate exacerbation (0.93, 0.82 to 1.07), with confidence intervals including the null value. Finally, SGLT-2 inhibitors were associated with a 38% decreased risk of severe exacerbation (2.4 v<\/em> 3.9 events per 100 person years; hazard ratio 0.62, 0.48 to 0.81) but not moderate exacerbation (1.02, 0.83 to 1.27).<\/p>\n\n\n\n

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Conclusions<\/strong> In this population based study, GLP-1 receptor agonists and SGLT-2 inhibitors were associated with a reduced risk of severe exacerbations compared with sulfonylureas in patients with chronic obstructive pulmonary disease and type 2 diabetes. DPP-4 inhibitors were not clearly associated with a decreased risk of chronic obstructive pulmonary disease exacerbations.<\/p>\n","protected":false},"excerpt":{"rendered":"

Research Novel antihyperglycaemic drugs and prevention […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23079"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23079"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23079\/revisions"}],"predecessor-version":[{"id":23080,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23079\/revisions\/23080"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23079"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23079"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23079"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}