Heterogeneous Treatment Effects on Cardiovascular Diseases With Dipeptidyl Peptidase-4 Inhibitors Versus Sulfonylureas in Type 2 Diabetes Patients.

摘要: This study explored heterogeneous treatment effects (HTEs) of the real-world use dipeptidyl peptidase-4 inhibitors (DPP-4is) vs. sulfonylureas (SUs) on cardiovascular diseases (CVDs) and mortality in patients with type 2 diabetes. Utilizing Taiwan's National Health Insurance Research Database, 19,853 propensity score-matched pairs DPP-4i SU stable users were identified. Classification regression tree analyses Cox models applied to explore HTEs, according various patient characteristics, composite CVDs, three-point major adverse event (MACE), all-cause mortality. The absolute risk difference (ARD), hazard ratio (HR), 95% confidence interval (CI) estimated for comparing effects. CVD history, ischemic stroke, or transient attack (IS/TIA) age at initiation significant effect modifiers. Patients prior IS/TIA but without any other CVDs benefited most reduced risks from using (ARD -4.31%, CI -7.48% -1.14%, HR 0.81, 0.69 ~ 0.95), followed by those initiated < 69.3 years -0.90%, -1.47% -0.32%, 0.86, 0.77 ~ 0.97). MACE -4.22%, CV -6.66% -1.78%, 0.80, 0.69 ~ 0.93), -0.68%, -1.08% -0.29%, 0.70 ~ 0.93). Consideration histories could facilitate individualized diabetes management SU. Future studies are warranted given hypothesis-generating nature this exploratory research.