Abstract
Purpose
We assessed whether sodium-glucose co-transporter type 2 (SGLT2) inhibitors are associated
with a higher incidence rate of venous thromboembolism in patients with type 2 diabetes.
Methods
We conducted a population-based cohort study using the InGef database including patients
with type 2 diabetes newly treated with noninsulin antidiabetic drugs between 2012
and 2018. Cases of venous thromboembolism identified during follow-up were matched
to 40 controls on age, sex, cohort entry date, and duration of follow-up. Using a
nested case-control approach, conditional logistic regression estimated incidence
rate ratios (RRs) with 95% confidence intervals (CIs) of venous thromboembolism adjusted
for sociodemographic and clinical variables, comparing current use of SGLT2 inhibitors
with current use of dipeptidyl peptidase-4 (DPP-4) inhibitors.
Results
In a cohort of 219,538 patients, we identified 2152 cases of venous thromboembolism
and matched them to 85,104 controls. Compared with DPP-4 inhibitors, current use of
SGLT2 inhibitors was associated with a lower rate of venous thromboembolism (RR, 0.75;
95% CI, 0.59-0.94). Effect estimates were similar for dapagliflozin (RR, 0.77; 95%
CI, 0.57-1.03) and empagliflozin (RR, 0.71; 95% CI, 0.52-0.98).
Conclusions
Compared with DPP-4 inhibitors, SGLT2 inhibitors were not associated with a higher
rate of venous thromboembolism, providing reassurance regarding their thromboembolic
safety.
Keywords
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Article Info
Publication History
Published online: December 11, 2020
Footnotes
Funding: This study was self-funded by the Institute for Applied Health Research Berlin – InGef.
Conflicts of Interest: NS left InGef and joined Bayer AG after conduct of the study, except for the revision of the manuscript during the peer-review process, all work by NS was performed under InGef affiliation. EG as employee of the Leibniz Institute for Prevention Research and Epidemiology – BIPS has performed research studies paid by pharmaceutical companies (Bayer-Schering, GSK, Novartis, Sanofi-Pasteur, Takeda) unrelated to this study and has been consultant to Bayer, Takeda, GSK, Astellas, AstraZeneca on topics unrelated to the subject of this study. DE, JW, and AD report none.
Authorship: All authors had access to the data and a role in writing this manuscript.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
