Evidence mapPaperPMID 39121166Full record

ArticlePloS one2024

Comparing the effects of biguanides and dipeptidyl peptidase-4 inhibitors on cardio-cerebrovascular outcomes, nephropathy, retinopathy, neuropathy, and treatment costs in diabetic patients.

Eiji Nakatani, Hiromitsu Ohno, Tatsunori Satoh, Daito Funaki, Chikara Ueki, Taku Matsunaga, Takayoshi Nagahama, Toru Tonoike, Hiromichi Yui, Akinori Miyakoshi and 5 more

Abstract readComparative Study
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Eiji NakataniGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.ORCID https://orcid.org/0000-0002-4876-446X
Hiromitsu OhnoAllied Medical K.K., Tokyo, Japan.
Tatsunori SatohGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Daito FunakiGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Chikara UekiGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Taku MatsunagaGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Takayoshi NagahamaAllied Medical K.K., Tokyo, Japan.
Toru TonoikeAllied Medical K.K., Tokyo, Japan.
Hiromichi YuiAllied Medical K.K., Tokyo, Japan.
Akinori MiyakoshiGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Yoshihiro TanakaGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Ataru IgarashiGraduate School of Pharmaceutical Sciences, University of Tokyo, Tokyo, Japan.
Hiraku KumamaruGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Nagato KuriyamaGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Akira SugawaraGraduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWestern guidelines often recommend biguanides as the first-line treatment for diabetes. However, dipeptidyl peptidase-4 (DPP-4) inhibitors, alongside biguanides, are increasingly used as the first-line therapy for type 2 diabetes (T2DM) in Japan. However, there have been few studies comparing the effectiveness of biguanides and DPP-4 inhibitors with respect to diabetes-related complications and cardio-cerebrovascular events over the long term, as well as the costs associated.

objectiveWe aimed to compare the outcomes of patients with T2DM who initiate treatment with a biguanide versus a DPP-4 inhibitor and the long-term costs associated.

methodsWe performed a cohort study between 2012 and 2021 using a new-user design and the Shizuoka Kokuho database. Patients were included if they were diagnosed with T2DM. The primary outcome was the incidence of cardio-cerebrovascular events or mortality from the initial month of treatment; and the secondary outcomes were the incidences of related complications (nephropathy, renal failure, retinopathy, and peripheral neuropathy) and the daily cost of the drugs used. Individuals who had experienced prior events during the preceding year were excluded, and events within 6 months of the start of the study period were censored. Propensity score matching was performed to compare between two groups.

resultsThe matched 1:5 cohort comprised 529 and 2,116 patients who were initially treated with a biguanide or a DPP-4 inhibitor, respectively. Although there were no significant differences in the incidence of cardio-cerebrovascular events or mortality and T2DM-related complications between the two groups (p = 0.139 and p = 0.595), daily biguanide administration was significantly cheaper (mean daily cost for biguanides, 61.1 JPY; for DPP-4 inhibitors, 122.7 JPY; p<0.001).

conclusionIn patients with T2DM who initiate pharmacotherapy, there were no differences in the long-term incidences of cardio-cerebrovascular events or complications associated with biguanide or DPP-4 use, but the former was less costly.

Indexed as

BiguanidesDiabetes Mellitus, Type 2Diabetic RetinopathyDipeptidyl-Peptidase IV InhibitorsAgedCardiovascular DiseasesCohort StudiesDiabetic NephropathiesDiabetic NeuropathiesFemaleHumansHypoglycemic AgentsJapanMaleMiddle AgedTreatment OutcomeBiguanidesDipeptidyl-Peptidase IV InhibitorsHypoglycemic Agents

Identifiers

PMID39121166
PMCPMC11315305

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.