DPP-4 inhibitors use not linked to pneumonia in diabetics, says study
Italy: The use of dipeptidyl-peptidase 4 inhibitors (DPP-4i) in people with type 2 diabetes is safe with regard to pneumonia risk, a recent study published in the journal Diabetes, Obesity and Metabolism has found.
DPP‐4i are a class of oral hypoglycemia drugs that block the enzyme dipeptidyl peptidase-4. They are used for the treatment of type 2 diabetes. There have been concerns regarding DPP-4i to be associated with pneumonia risk. Mario Luca Morieri, University of Padova, Padova, Italy, and colleagues analyzed observational data and clinical trials to explore whether the use of DPP‐4i modifies the risk of pneumonia.
The researchers identified diabetes patients in the Veneto Region administrative database. They performed propensity score matching (PSM) between new users of DPP‐4 inhibitors and new users of other oral glucose-lowering medications (OGLM). The rate of hospitalization for pneumonia between matched cohorts were then compared using the Cox proportional hazard model. The same analysis was repeated using the database of a local diabetes outpatient clinic.
Similar observational studies from the literature were retrieved by the researchers to perform a meta‐analysis. Results from trials reporting pneumonia rates among patients randomized to DPP‐4 inhibitors versus placebo/active comparator were also meta-analyzed.
Key findings of the study include:
- In the Regional database, after matching 6495 patients/group, new users of DPP‐4 inhibitors had a lower rate of hospitalization for pneumonia than new users of other OGLM (HR 0.76).
- In the outpatient database, after matching 867 patients/group, new users of DPP‐4 inhibitors showed a non‐significantly lower rate of hospitalization for pneumonia (HR 0.65).
- The meta‐analysis of observational studies yielded an overall non‐significant lower risk of hospitalization for pneumonia among DPP‐4i users (RR 0.81).
- The meta‐analysis of randomized controlled trials showed no overall effect of DPP‐4i on pneumonia risk (RR 1.06).
"Use of DPP‐4i can be considered safe with regards to the risk of pneumonia," concluded the authors.
The study, "Exposure to DPP ‐4 inhibitors and risk of pneumonia among people with type 2 diabetes. Retrospective cohort study and meta‐analysis," is published in the journal Diabetes, Obesity and Metabolism.