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KMID : 0370220200640050402
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Yakhak Hoeji
2020 Volume.64 No. 5 p.402 ~ p.408
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Risk of Diabetic Retinopathy associated with Dipeptidyl Peptidase-4 Inhibitor as an Add-on Therapy to Metformin in Type 2 Diabetes Mellitus
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Choi Eun-Mi
Chung Soo-Youn
Kim Bong-Gi
Ahn Jeong-Hoon
Han Soon-Young
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Abstract
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This study examined whether using dipeptidyl-peptidase-4 inhibitors (DPP4i) increases(or lowers) the risk ofdiabetic retinopathy compared to sulfonylurea (SU) or thiazolidinedione (TZD) as an add-on therapy to metformin (Met)in patients with type 2 diabetes (T2D). A nationwide, population-based cohort study was conducted using the Koreanational health insurance claims database from 2011 through 2015. From the cohort, 146,137 adults with T2D wereidentified as having been treated with oral glucose-lowering agents (DPP-4i, SU, TZD) in addition to Met therapy between2012 and 2014. Cox regression analysis was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) fordiabetic retinopathy. Total 16,517 cases of diabetic retinopathy occurred; 9,721 in DPP-4i+Met group, 659 in TZD+Metgroup and 6,137 in SU+Met group. The crude incidence rate was 54.8 cases per 1,000 person-years in DPP-4i+Met groupcompared with 47.1 in SU+Met group. Compared to SU as an add-on therapy to Met, DPP-4i significantly reduced therisk of diabetic retinopathy: the adjusted HRs was 0.87 (95% CI, 0.84-0.90). People with diabetes are at high risk ofdeveloping diabetic retinopathy. Since diabetic retinopathy is a serious complication that affects vision, managing diabeticretinopathy can improve the quality of life for diabetes patients. Our study showed that DPP-4i did not increase the riskof diabetic retinopathy compared to SU when used as a combination therapy with Met.
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KEYWORD
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dipeptidyl peptidase-4 inhibitor, diabetic retinopathy, cohort study, drug safety
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