Format

Send to

Choose Destination
Diabetes Obes Metab. 2020 Feb;22(2):254-262. doi: 10.1111/dom.13893. Epub 2019 Nov 3.

Comparative cardiovascular and hypoglycaemic safety of glimepiride in type 2 diabetes: A population-based cohort study.

Author information

1
Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.
2
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
3
Institute of Clinical Pharmacology and Toxicology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
4
Division of Endocrinology, Jewish General Hospital, Montreal, Quebec, Canada.
5
Division of Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Quebec, Canada.

Abstract

AIM:

To assess the incidence of cardiovascular and hypoglycaemic adverse events associated with glimepiride compared with other second-generation sulphonylureas among patients with type 2 diabetes in a real-world clinical setting.

MATERIALS AND METHODS:

We identified all sulphonylurea initiators between 1998 and 2017 in the UK Clinical Practice Research Datalink. Using a prevalent new-user design, glimepiride initiators were matched 1:4 with initiators of other second-generation sulphonylureas on calendar time, prior sulphonylurea use, and time-conditional high-dimensional propensity score. Cox proportional hazards models yielded adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for myocardial infarction, ischaemic stroke, severe hypoglycaemia, cardiovascular death, and all-cause mortality.

RESULTS:

Among 66 032 sulphonylurea new users, 6438 initiated glimepiride and were matched to up to 20 582 initiators of other second-generation sulphonylureas. During a mean follow-up of 1.3 years, glimepiride was associated with a similar incidence of myocardial infarction (HR 0.99, 95% CI 0.75-1.30) and ischaemic stroke (HR 0.96, 95% CI 0.72-1.27) compared with other second-generation sulphonylureas, while there was a non-significant trend towards a higher incidence of severe hypoglycaemia (HR 1.24, 95% CI 0.92-1.68). Glimepiride was also associated with a lower incidence of all-cause mortality (HR 0.77, 95% CI 0.67-0.89), and a non-significant but similar trend for cardiovascular death (HR 0.83, 95% CI 0.65-1.05).

CONCLUSIONS:

Glimepiride was associated with a lower incidence of all-cause mortality compared with other second-generation sulphonylureas.

KEYWORDS:

CAROLINA; cardiovascular disease; pharmaco-epidemiology; type 2 diabetes

PMID:
31596043
DOI:
10.1111/dom.13893

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center