Evidence mapPaperPMID 39645259Full record

ArticleThorax2024

Comparative estimate of glucose-lowering therapies on risk of incident pneumonia and severe sepsis: an analysis of real-world cohort data.

Alex E Henney, David R Riley, Theresa J Hydes, Matthew Anson, Gema H Ibarburu, Frederick Frost, Uazman Alam, Daniel J Cuthbertson

Abstract readComparative Study
In one paragraph

Article in Thorax, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing 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

14 citing papers in PubMed.

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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

8 authors.

Alex E HenneyDepartment of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK.ORCID 0000-0002-8066-9470
David R RileyDepartment of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK.ORCID 0000-0002-0905-6524
Theresa J HydesDepartment of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK.
Matthew AnsonDepartment of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK.
Gema H IbarburuTriNetX LLC, Cambridge, Massachusetts, USA.
Frederick FrostLiverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK.
Uazman AlamDepartment of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK.
Daniel J CuthbertsonDepartment of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK dan.cuthbertson@liverpool.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are treatments for type 2 diabetes (T2D). Beyond glucose-lowering and cardiorenal protection, these drugs may protect against pneumonia and sepsis.

aimsThis study assesses the impact of SGLT2i and GLP-1 RAs on the risk of incident pneumonia and severe sepsis.

methodsA retrospective cohort study was conducted using anonymised electronic medical records from TriNetX, a global federated database. Two intention-to-treat analyses were performed, each with two cohorts of adult T2D patients. The first analysis compared individuals prescribed SGLT2i, and the second individuals prescribed GLP-1 RAs, with those prescribed dipeptidyl peptidase-4 inhibitors (DPP-4i). An active comparator new user design was used, with outcomes defined as time-to-incident pneumonia and severe sepsis. Propensity score matching (1:1) was applied to control for potential confounders, and patients were followed for 12 months. Secondary analyses compared SGLT2i and GLP-1 RAs against other glucose-lowering therapies.

resultsAfter propensity score matching, 352 687 patients were included in the SGLT2i versus DPP-4i comparison. SGLT2i treatment was associated with a risk reduction in incident pneumonia (HR 0.75 (95% CI 0.73, 0.78)) and severe sepsis (0.75 (0.73, 0.77)). In the GLP-1 RA versus DPP-4i comparison, 331 863 patients were included. GLP-1 RA treatment was associated with a risk reduction in incident pneumonia (0.60 (0.58, 0.62)) and severe sepsis (0.61 (0.59, 0.63)).

conclusionSGLT2i and GLP-1 RAs are associated with a reduced risk of incident pneumonia and severe sepsis in patients with T2D. Further research and focused randomised controlled trials are warranted to explore the broader clinical implications of these treatments.

Indexed as

Diabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsPneumoniaSepsisSodium-Glucose Transporter 2 InhibitorsAgedFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsBacterial InfectionClinical EpidemiologyInfection ControlPneumoniaRespiratory Infection

Identifiers

PMID39645259
PMCPMC11671942

What Socratic holds

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Registered trials

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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.