| アブストラクト | BACKGROUND: Incretin-based drugs, namely glucagon-like peptide 1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase 4 (DPP-4) inhibitors, may have neuroprotective effects. Thus, we assessed whether these drugs are associated with a decreased risk of dementia among patients with type 2 diabetes. METHODS: Using the Clinical Practice Research Datalink from the UK, we formed two new user cohorts of patients at least 50 years of age with type 2 diabetes starting incretin-based drugs or sulfonylureas between 2007 and 2021. Hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia were estimated separately for GLP-1 RAs and DPP-4 inhibitors using Cox proportional hazards models with propensity score fine-stratification weighting and inverse probability of censoring weights. RESULTS: Among 275,144 initiators of DPP-4 inhibitors or sulfonylureas, followed for 750,846 person-years, DPP-4 inhibitors were associated with a reduced dementia risk compared with sulfonylureas (4.4 vs. 5.7 events per 1000 person-years; HR 0.77, 95% CI 0.71-0.85). HRs decreased with increasing cumulative duration of use and dose. Similar associations were observed across dementia subtypes and individual DPP-4 inhibitors molecules. Among 181,215 initiators of GLP-1 RAs or sulfonylureas, followed for 530,415 person-years, GLP-1 RAs were associated with a similar reduction in dementia risk compared with sulfonylureas, although with high uncertainty (2.3 vs. 3.1 events per 1000 person-years; HR 0.74, 95% CI 0.46-1.18). The magnitude of the association increased with cumulative duration of use and dose but with high uncertainty. CONCLUSIONS: In this population-based study, DPP-4 inhibitors, and possibly GLP-1 RAs, were associated with a reduced dementia risk compared with sulfonylureas. |
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| ジャーナル名 | Drug safety |
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| Pubmed追加日 | 2025/10/22 |
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| 投稿者 | Wang, Yun-Han; Johnson, Kyle; Beradid, Sarah; Yin, Hui; Yu, Oriana H Y; Suissa, Samy; Azoulay, Laurent; Renoux, Christel |
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| 組織名 | Department of Epidemiology, Biostatistics and Occupational Health, McGill;University, Montreal, Canada.;Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research,;Jewish General Hospital, 3755 Cote Sainte Catherine H 416.1, Montreal, QC, H3T;1E2, Canada.;Division of Endocrinology, Jewish General Hospital, Montreal, Canada.;Department of Medicine, McGill University, Montreal, Canada.;Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada.;University, Montreal, Canada. christel.renoux@mcgill.ca.;1E2, Canada. christel.renoux@mcgill.ca.;christel.renoux@mcgill.ca.;Department of Neurology and Neurosurgery, McGill University, Montreal, Canada. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41123870/ |
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