Use of dipeptidyl peptidase‐4 inhibitors and risk of splanchnic vein thrombosis: A Danish nationwide new‐user active comparator cohort study
Use of dipeptidyl peptidase‐4 inhibitors and risk of splanchnic vein thrombosis: A Danish nationwide new‐user active comparator cohort study
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二肽基肽酶 4 抑制剂的使用和内脏静脉血栓形成的风险：丹麦全国新用户主动比较队列研究
DOI：
10.1111/dom.14253
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发表时间：
2020
期刊：
影响因子：
7.7
通讯作者：
K. Kristensen
中科院分区：
文献类型：
--
作者：
A. Pottegård;L. Lund;D. Henriksen;L. Folkestad;M. Hellfritzsch;J. Hallas;K. Kristensen
根据自发性不良事件报告，最近怀疑二肽基肽酶-4（DPP-4）抑制剂的使用可导致内脏静脉血栓形成。在本文中，我们报告了一项基于人群的新使用者活性对照药物队列研究的结果，该研究讨论了这一假设，比较了DPP-4抑制剂启动者（n = 75 042）与胰高血糖素样肽-1受体激动剂（GLP-1 RA）或钠-葡萄糖协同转运蛋白-2（SGLT-2）抑制剂启动者（n = 38 718）。我们使用考克斯回归估计了DPP-4抑制剂使用与内脏静脉血栓形成风险相关的风险比（HR）。在一项粗略分析中，DPP-4抑制剂启用者中内脏静脉血栓形成的发生率为0.22/1000人年，GLP-1 RA/SGLT 2抑制剂启用者中为0.17，对应于0.05的未调整绝对发生率差异（95%置信区间[CI] -0.04至0.14），HR为1.29（95% CI 0.78至2.15）。使用稳定的治疗加权逆概率调整潜在混杂因素，我们获得的绝对发生率差异为0.03/1000人-年（95% CI -0.07至0.14），HR为1.18（95% CI 0.62至2.26）。在补充分析中未发现内脏静脉血栓形成风险增加的证据，包括缺乏任何剂量反应模式。因此，我们发现DPP-4抑制剂的使用与内脏静脉血栓形成风险之间无相关性。
Use of dipeptidyl peptidase‐4 (DPP‐4) inhibitors, on the basis of spontaneous adverse event reports, has recently been suspected of causing splanchnic vein thrombosis. Here, we report the results of a population‐based new‐user active comparator cohort study addressing this hypothesis, comparing DPP‐4 inhibitor initiators (n = 75 042) with initiators of glucagon‐like‐peptide‐1 receptor agonists (GLP‐1RAs) or sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors (n = 38 718). We estimated the hazard ratio (HR) associating DPP‐4 inhibitor use with risk of splanchnic vein thrombosis using Cox regression. In a crude analysis, the incidence rate of splanchnic vein thrombosis was 0.22/1000 person‐years among DPP‐4 inhibitor initiators, compared to 0.17 among GLP‐1RA/SGLT2 inhibitor initiators, corresponding to an unadjusted absolute incidence rate difference of 0.05 (95% confidence interval [CI] –0.04 to 0.14) and an HR of 1.29 (95% CI 0.78 to 2.15). Adjusting for potential confounders using stabilized inverse probability of treatment weighing, we obtained an absolute incidence rate difference of 0.03/1000 person‐years (95% CI –0.07 to 0.14) and an HR of 1.18 (95% CI 0.62 to 2.26). No evidence of increased risk of splanchnic vein thrombosis was found in supplementary analyses, including an absence of any dose–response patterns. As such, we found no association between DPP‐4 inhibitor use and splanchnic vein thrombosis risk.