Visual Abstract

Background: Head-to-head studies of metformin (MET) vs. SGLT2i or GLP1Ra as first line treatment are needed.

Aims: To compare new users of SGLT2i or GPL1Ra vs. MET in terms of time to hospitalization for heart failure (HF), myocardial infarction (MI), stroke, or development of chronic kidney disease (CKD) (stage III-V).

Methods: Cohort of T2DM patients with cardiovascular risk factors, initiating either MET, SGLT2i or GLP1Ra, between 2014-18, without any antidiabetic drugs in the prior year, in the IBM MarketScan® Databases. Patients were followed from first dispensation to: change in treatment, insurance coverage loss, or 31-Dec-2018. Patients from the SGLT2i or GLP1Ra cohorts were matched on propensity score to MET patients (ratio 1:2). Differences in outcomes were estimated via Cox proportional hazard models.

Results: A total of 5,181 SGLT2i and 6,164 GLP1Ra patients were matched to 10,361 and 12,326 MET patients, respectively. After matching, baseline characteristics were similar. Results are displayed in Figure 1.

Conclusion: As compared to MET, a trend toward a decreased risk of hospitalization for HF was seen with SGLT2i, a trend toward a decreased risk of hospitalization for stroke with GLP1Ra, and an increased risk of CKD with SGLT2i and GLP1Ra. Metformin may offer renal benefit, which needs to be further assessed.

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Disclosure

C. Foch: Employee; Self; Merck KGaA. A. Allignol: Employee; Self; Merck KGaA. E. Boutmy: None. K. Brand: Employee; Self; Merck KGaA.

Funding

Merck KGaA

© 2021 by the American Diabetes Association
2021
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