![]() Therefore, it is important to characterize the effectiveness of diabetes therapies in reducing the CVD risk.ĭapagliflozin is a sodium-glucose co-transporter 2 inhibitor (SGLT2i) that blocks glucose resorption in the proximal tubule of the kidney and promotes glucosuria. Patients with diabetes have an increased risk of developing cardiovascular disease (CVD), the leading cause of mortality in patients with diabetes ( Fox et al., 2004 Fox et al., 2007 Franco et al., 2007). These data provide valuable information to patients, practitioners, and authorities regarding the risk of CV events associated with dapagliflozin versus DPP-4i use in clinical practice. In this population-based cohort study, the use of dapagliflozin instead of DPP-4i was associated with a reduced risk of MACE, which subsequently reduced direct medical costs. The estimated direct medical cost appeared to be lower by $68,452 in the dapagliflozin group than that in the DPP-4i group for 3 years, in 1,000 hypothetical patients. The corresponding HRs were consistent among patients with and without underlying CV disease. The adjusted HR of MACE for dapagliflozin compared with that for DPP-4i was 0.69 (95% CI 0.57–0.83). During the follow-up, 184 patients receiving dapagliflozin and 3,674 receiving DPP-4i (incidence, 6.47 and 11.33 events/1,000 person-years, respectively) had MACE. Of the 260,336 patients in the cohort, 23,147 and 237,189 received dapagliflozin and DPP-4i, respectively. A decision analytic model was used to compare direct medical costs between the two treatment groups from a healthcare provider’s perspective. Proportional hazard models after propensity score weighting were used to determine hazard ratios (HRs) and 95% confidence intervals (CIs) for MACE in the dapagliflozin and DPP-4i groups. The primary outcome was the incidence of a composite of major adverse CV events (MACEs)-nonfatal myocardial infarction, nonfatal stroke, or in-hospital CV death. Patients who were prescribed dapagliflozin and DPP-4i for the first time were included. A retrospective cohort study was conducted using national health insurance claims data from September 1, 2014, to June 30, 2018, of patients in Korea. This study compared dapagliflozin, a sodium-glucose co-transporter 2 inhibitor, and dipeptidyl peptidase-4 inhibitors (DPP-4i) with regard to cardiovascular (CV) event incidence and direct medical costs during type 2 diabetes treatment. 4College of Pharmacy, CHA University, Pocheon-si, South Korea.3Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea.2Pharmaceutical Information Research Institute, CHA University, Seongnam, South Korea.1Research Institute for Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea.Jong-Mi Seong 1 Jong Joo Kim 2 Hae Jin Kim 3* Hyun Soon Sohn 4*
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