PreprintArticleVersion 1Preserved in Portico This version is not peer-reviewed
Pioglitazone is Associated with Lower Major Adverse Cardiovascular and Cerebrovascular Events than DPP4-Inhibitors in Diabetic Patients with End-Stage Renal Disease: A Taiwan Nationwide Cohort Study, 2006-2016
Lin, M.-H.; Yang, H.-Y.; Yen, C.-L.; Wu, C.-Y.; Jenq, C.-C.; Kuo, G.; Peng, W.-S.; Liu, J.-R.; Tian, Y.-C.; Yang, C.-W.; Anderson, G.F.; See, L.-C. Pioglitazone Is Associated with Lower Major Adverse Cardiovascular and Cerebrovascular Events than DPP4-Inhibitors in Diabetic Patients with End-Stage Renal Disease: A Taiwan Nationwide Cohort Study, 2006–2016. J. Clin. Med.2020, 9, 3578.
Lin, M.-H.; Yang, H.-Y.; Yen, C.-L.; Wu, C.-Y.; Jenq, C.-C.; Kuo, G.; Peng, W.-S.; Liu, J.-R.; Tian, Y.-C.; Yang, C.-W.; Anderson, G.F.; See, L.-C. Pioglitazone Is Associated with Lower Major Adverse Cardiovascular and Cerebrovascular Events than DPP4-Inhibitors in Diabetic Patients with End-Stage Renal Disease: A Taiwan Nationwide Cohort Study, 2006–2016. J. Clin. Med. 2020, 9, 3578.
Lin, M.-H.; Yang, H.-Y.; Yen, C.-L.; Wu, C.-Y.; Jenq, C.-C.; Kuo, G.; Peng, W.-S.; Liu, J.-R.; Tian, Y.-C.; Yang, C.-W.; Anderson, G.F.; See, L.-C. Pioglitazone Is Associated with Lower Major Adverse Cardiovascular and Cerebrovascular Events than DPP4-Inhibitors in Diabetic Patients with End-Stage Renal Disease: A Taiwan Nationwide Cohort Study, 2006–2016. J. Clin. Med.2020, 9, 3578.
Lin, M.-H.; Yang, H.-Y.; Yen, C.-L.; Wu, C.-Y.; Jenq, C.-C.; Kuo, G.; Peng, W.-S.; Liu, J.-R.; Tian, Y.-C.; Yang, C.-W.; Anderson, G.F.; See, L.-C. Pioglitazone Is Associated with Lower Major Adverse Cardiovascular and Cerebrovascular Events than DPP4-Inhibitors in Diabetic Patients with End-Stage Renal Disease: A Taiwan Nationwide Cohort Study, 2006–2016. J. Clin. Med. 2020, 9, 3578.
Abstract
While pioglitazone reduces insulin resistance and hepatic gluconeogenesis effectively in patients with T2DM, these benefits remained controversial in patients with ESRD. We compared MACCEs and mortality (overall, infection-related, and MACCE-related) of pioglitazone to that of DPP4-inhibitors in patients with T2DM and ESRD. From Taiwan’s national health insurance database, 647 pioglitazone users and 6080 DPP4-inhibitors users between April 1st, 2006 and December 31th, 2016 were followed from the 91th date after the ESRD certification till study outcomes, independently; withdraw from the NHI program, death, or Dec. 31th, 2017. After weighting, risks of MACCEs (10.48% vs 12.62% per person-years, [HR]: 0.85, 95% [CI]: 0.729–0.985) and all-cause mortality (12.86% vs 13.22% per person-years, [HR]: 0.88, 95% [CI]: 0.771–0.995) are significantly lower in pioglitazone group. Subgroup analysis found lower MACCEs risk in the pioglitazone users without insulin therapy (6.44% vs 10.04% [HR]: 0.59, 95% [CI]: 0.42–0.82) and lower MACCEs related death (2.76% vs 3.84% [HR]: 0.61, 95% [CI]: 0.40–0.95) in the pioglitazone group with dyslipidemia, when comparing with DPP4-inhibitors users. Pioglitazone is associated with lower all-cause mortality and MACCEs in diabetic patients with ESRD, compared to DPP4-inhibitors. These benefits were further significant in the non-insulin users and patients with dyslipidemia.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
