Sulphonylureas (SUs) are a commonly used medicine for patients with type 2 diabetes. However, there are some concerns about the safety of the SUs. Use of SUs might increase the risk of death or a heart attack when compared to metformin users (another commonly used medicine for type 2 diabetes). Gliclazide is currently the SU of first choice in many countries as use is related to a lower risk of a heart conditions and death than other SUs. However, study results about the risk of heart conditions and death vary between studies. As result, it is still not clear which SU is safest to use. Therefore, the aim of this study is to evaluate the relation between the current use of different SUs and the risk of death or a heart attack.
This study's primary objective is to evaluate the effect of current use of different types of sulphonylureas (SUs) only and the risk of myocardial infarction (MI). Our primary analysis will compare gliclazide (reference group) and glimepiride (primary exposure group). Additional analyses will compare gliclazide users with users of other sulphonylureas or other non-insulin antidiabetic agents (NIAAs). Our secondary objective is to evaluate the effect of current use of different types of sulphonylureas (SUs) only and the risk of all-cause mortality. Within the CPRD, all adult patients with at least one NIAA prescription will be selected. The exposure of interest is use of SUs in patients with type 2 diabetes mellitus (T2DM). Exposure will be assessed in a time-dependent manner. Adjusted cox regression models will be used to derive hazard ratios for the association between use of different SUs and the risk of all-cause mortality and myocardial infarction.
Risk of myocardial infarction; Risk of all-cause mortality.
Frank de Vries - Chief Investigator - Utrecht University
Frank de Vries - Corresponding Applicant - Utrecht University
Andre Krings - Collaborator - Atrium MC
Andrea Burden - Collaborator - ETH Zurich
Johanna Driessen - Collaborator - Utrecht University
Judith van Dalem - Collaborator - Utrecht University
Martijn Brouwers - Collaborator - Maastricht University
Olaf Klungel - Collaborator - Utrecht University