Next Article in Journal
Dental Caries Diagnosis and Detection Using Neural Networks: A Systematic Review
Previous Article in Journal
CAR T-Cells in Multiple Myeloma Are Ready for Prime Time
Open AccessArticle

Pioglitazone Is Associated with Lower Major Adverse Cardiovascular and Cerebrovascular Events than DPP4-Inhibitors in Diabetic Patients with End-Stage Renal Disease: A Taiwan Nationwide Cohort Study, 2006–2016

1
Nephrology Department, Kidney Research Institute, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
2
Department of Health Policy and Management, Johns Hopkins Bloomberg, School of Public Health, Baltimore, MD 21205, USA
3
Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333, Taiwan
4
Department of Public Health, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
5
Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
6
Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan 333, Taiwan
*
Author to whom correspondence should be addressed.
Both authors contributed equally to this manuscript.
J. Clin. Med. 2020, 9(11), 3578; https://doi.org/10.3390/jcm9113578
Received: 30 September 2020 / Revised: 30 October 2020 / Accepted: 3 November 2020 / Published: 6 November 2020
(This article belongs to the Section Nephrology & Urology)
While pioglitazone reduces insulin resistance and hepatic gluconeogenesis effectively in patients with type 2 diabetes mellitus (T2DM), these benefits remained controversial in patients with end stage renal disease (ESRD). We compared major adverse cardiac cerebrovascular events (MACCEs) and mortality (overall, infection-related, and MACCE-related) of pioglitazone to that of dipeptidyl peptidase 4 inhibitors (DPP4-inhibitors) in patients with T2DM and ESRD. From Taiwan’s national health insurance research database (NHIRD), 647 pioglitazone users and 6080 DPP4-inhibitors users between 1 April 2006 and 31 December 2016 were followed from the 91th date after the ESRD certification until the study outcomes, independently; withdraw from the NHI program, death, or 31 December 2017, whichever came first. After weighting, risks of MACCEs (10.48% vs. 12.62% per person-years, hazard ratio (HR): 0.85, 95% (CI): 0.729–0.985) and all-cause mortality (12.86% vs. 13.22% per person-years, (HR): 0.88, 95% (CI): 0.771–0.995) are significantly lower in pioglitazone group. Subgroup analysis found lower MACCEs risk in the pioglitazone users without insulin therapy (6.44% vs. 10.04% (HR): 0.59, 95% (CI): 0.42–0.82) and lower MACCEs related death (2.76% vs. 3.84% (HR): 0.61, 95% (CI): 0.40–0.95) in the pioglitazone group with dyslipidemia, when comparing with DPP4-inhibitors users. Pioglitazone is associated with lower all-cause mortality and MACCEs in diabetic patients with ESRD, compared to DPP4-inhibitors. These benefits were even more significant in the non-insulin users and patients with dyslipidemia. View Full-Text
Keywords: Pioglitazone; DPP4-inhibitor; ESRD; cardiovascular outcome; mortality Pioglitazone; DPP4-inhibitor; ESRD; cardiovascular outcome; mortality
Show Figures

Figure 1

MDPI and ACS Style

Lin, M.-H.; Yang, H.-Y.; Yen, C.-L.; Wu, C.-Y.; Jenq, C.-C.; Kuo, G.; Peng, W.-S.; Liu, J.-R.; Tian, Y.-C.; Yang, C.-W.; Anderson, G.F.; See, L.-C. Pioglitazone Is Associated with Lower Major Adverse Cardiovascular and Cerebrovascular Events than DPP4-Inhibitors in Diabetic Patients with End-Stage Renal Disease: A Taiwan Nationwide Cohort Study, 2006–2016. J. Clin. Med. 2020, 9, 3578. https://doi.org/10.3390/jcm9113578

AMA Style

Lin M-H, Yang H-Y, Yen C-L, Wu C-Y, Jenq C-C, Kuo G, Peng W-S, Liu J-R, Tian Y-C, Yang C-W, Anderson GF, See L-C. Pioglitazone Is Associated with Lower Major Adverse Cardiovascular and Cerebrovascular Events than DPP4-Inhibitors in Diabetic Patients with End-Stage Renal Disease: A Taiwan Nationwide Cohort Study, 2006–2016. Journal of Clinical Medicine. 2020; 9(11):3578. https://doi.org/10.3390/jcm9113578

Chicago/Turabian Style

Lin, Min-Hao; Yang, Huang-Yu; Yen, Chieh-Li; Wu, Chao-Yi; Jenq, Chang-Chyi; Kuo, George; Peng, Wei-Sheng; Liu, Jia-Rou; Tian, Ya-Chung; Yang, Chih-Wei; Anderson, Gerard F.; See, Lai-Chu. 2020. "Pioglitazone Is Associated with Lower Major Adverse Cardiovascular and Cerebrovascular Events than DPP4-Inhibitors in Diabetic Patients with End-Stage Renal Disease: A Taiwan Nationwide Cohort Study, 2006–2016" J. Clin. Med. 9, no. 11: 3578. https://doi.org/10.3390/jcm9113578

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Search more from Scilit
 
Search
Back to TopTop