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Sodium-glucose co-transporter 2 inhibitor therapy reduces the administration frequency of anti-vascular endothelial growth factor agents in patients with diabetic macular oedema with a history of anti-vascular endothelial growth factor agent use: A cohort study using the Japanese health insurance claims database.

Author information

Affiliations

  • 1. Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Kimitsu Chuo Hospital, Kisarazu, Japan.
      Authors
    • Ishibashi R 1, 3
    (1 author)
  • 2. Clinical Research Center, Chiba University Hospital, Chiba, Japan.
      Authors
    • Inaba Y 2
    • Shiko Y 2
    • Kawasaki Y 2
    (3 authors)
  • 3. Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan.
      Authors
    • Ishibashi R 1, 3
    • Koshizaka M 3
    • Maezawa Y 3
    • Yokote K 3
    (4 authors)
  • 4. Department of Ophthalmology, Chiba Rosai Hospital, Ichihara, Japan.
      Authors
    • Takatsuna Y 4, 5
    (1 author)
  • 5. Department of Ophthalmology and Vision Science, Chiba University Graduate School of Medicine, Chiba, Japan.
      Authors
    • Takatsuna Y 4, 5
    • Tatsumi T 5
    • Yamamoto S 5
    (3 authors)
    • Show all (6)

ORCIDs linked to this article

Diabetes, Obesity & Metabolism, 19 Jan 2024, 26(4):1510-1518
https://doi.org/10.1111/dom.15454 PMID: 38240052 

Abstract 

Aim

We assessed the effectiveness of sodium-glucose co-transporter 2 inhibitors (SGLT2is) in reducing the administration frequency of anti-vascular endothelial growth factor (VEGF) agents in patients with diabetic macular oedema (DMO) using a health insurance claims database.

Materials and methods

This retrospective cohort study analysed health insurance claims data covering 11 million Japanese patients between 2005 and 2019. We analysed the frequency and duration of intravitreal injection of anti-VEGF agents after initiating SGLT2is or other antidiabetic drugs.

Results

Among 2412 matched patients with DMO, the incidence rates of anti-VEGF agent injections were 230.1 per 1000 person-year in SGLT2i users and 228.4 times per 1000 person-year in non-users, respectively, and the risk ratio for events was unchanged in both groups. Sub-analysis of each baseline characteristic of the patients showed that SGLT2is were particularly effective in patients with a history of anti-VEGF agent use [p = .027, hazard ratio (HR): 0.44, 95% confidence interval (CI): 0.22-0.91]. SGLT2is reduced the risk for the first (p = .023, HR: 0.45, 95% CI: 0.22-0.91) and second (p = .021, HR: 0.39, 95% CI: 0.17-0.89) anti-VEGF agent injections.

Conclusions

There was no difference in the risk ratio for the addition of anti-VEGF therapy between the two treatment groups. However, the use of SGLT2is reduced the frequency of anti-VEGF agent administration in patients with DMO requiring anti-VEGF therapy. Therefore, SGLT2i therapy may be a novel, non-invasive, low-cost adjunctive therapy for DMO requiring anti-VEGF therapy.

Full text links 

Read article at publisher's site: https://doi.org/10.1111/dom.15454

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Funding 

Funders who supported this work.

Astellas Pharma Inc

    Astellas Pharma US