SGLT2 Inhibitors vs DPP-4 Inhibitors: Which is Tied to Less Renal Risk?

Treatment with sodium-glucose co-transporter 2 (SGLT2) inhibitors is associated with lower risk of serious renal events that treatment with dipeptidyl peptidase-4 (DPP-4) inhibitors, according to the results of a recent study.

The researchers conducted a cohort study involving 29,887 participants who began SGLT2 inhibitor treatment and 29,887 new users of DPP-4 inhibitors. The participants were matched 1:1 using a propensity score with 57 variables. Of the participants, 11,108 had cardiovascular disease and 1974 had chronic kidney disease.

Overall, use of SGLT2 inhibitors was associated with reduced risk of serious renal events (2.6 events per 1000 person years) compared with use of DPP-4 inhibitors (6.2 events per 1000 person years).

Hazard ratios for renal replacement therapy, hospital admission for renal events, and death from renal causes were 0.31, 0.41, and 0.77, respectively, for use of SGLT2 inhibitors compared with DPP-4 inhibitors.

“In this analysis of nationwide registers from three countries, use of SGLT2 inhibitors, compared with DPP-4 inhibitors, was associated with a reduced risk of serious renal events. Complementing data from clinical trials, this study provides further support for the use of SGLT2 inhibitors in a broad range of patients with type 2 diabetes,” the researchers concluded.

—Michael Potts

Reference:
Pasternak B, Wintzell V, Melbye M, et al. Use of sodium-glucose co-transporter 2 inhibitors and risk of serious renal events: Scandinavian cohort study. Published online April 29, 2020. BMJ. doi: 10.1136/bmj.m1186