| アブストラクト | PURPOSE: To determine whether combination of sulfonylureas and metformin increases the risk of death from any cause in patients with type 2 diabetes. METHODS: A nested case-control study was conducted within a population-based cohort from the UK General Practice Research Database (GPRD). The cohort included patients over the age of 40 who were prescribed a first oral hypoglycaemic agent between 1 January 1988 and 30 June 2008. Cases included all patients who deceased during follow-up. Up to 10 controls were matched to each case on year of birth, date of cohort entry (+/-1 year) and duration of follow-up. Conditional logistic regression was used to estimate rate ratios (RRs) of death from any cause associated with the use of combination of sulfonylureas and metformin, relative to sulfonylurea monotherapy. RESULTS: The cohort comprised 84 231 users of oral hypoglycaemic agents, of whom 14 996 died from any cause during a mean of 4.3 years of follow-up (mortality rate 4.1 per 100 per year). Patients currently exposed to a combination of sulfonylureas and metformin were at a decreased risk of death from any cause compared to patients exposed to sulfonylurea monotherapy (adjusted RR: 0.77, 95%CI: 0.70, 0.85). Similar results were obtained for patients currently exposed to metformin monotherapy (adjusted RR: 0.70, 95%CI: 0.64, 0.75) when compared to sulfonylurea monotherapy. Patients had to be exposed to the combination therapy for at least 4 months prior to index date to experience a lower risk of mortality compared to sulfonylurea monotherapy. CONCLUSIONS: The combination of sulfonylureas and metformin does not increase the risk of death. In contrast, it may moderately reduce this risk compared to sulfonylurea monotherapy. |
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| ジャーナル名 | Pharmacoepidemiology and drug safety |
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| 投稿日 | 2010/01/07 |
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| 投稿者 | Azoulay, Laurent; Schneider-Lindner, Verena; Dell'aniello, Sophie; Schiffrin, Alicia; Suissa, Samy |
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| 組織名 | Division of Clinical Epidemiology, SMBD-Jewish General Hospital, Montreal,;Quebec, Canada. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/20052677/ |
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