tetano
Editor, Senior Moderator
BMJ Open Diabetes Res Care
. 2025 Aug 7;13(4):e004677.
doi: 10.1136/bmjdrc-2024-004677. Association between dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists and COVID-19 infection and adverse outcomes: a cohort study
Wade Thompson[SUP] 1 2 3 [/SUP], Bing Yu[SUP] 2 [/SUP], Joan Porter[SUP] 2 [/SUP], Jiming Fang[SUP] 2 [/SUP], Laura E Ferreira-Legere[SUP] 2 [/SUP], Peter C Austin[SUP] 2 4 5 [/SUP], Cynthia A Jackevicius[SUP] 2 4 6 [/SUP], Heather Ross[SUP] 7 8 [/SUP], Douglas S Lee[SUP] 2 4 7 9 [/SUP], Alanna Weisman[SUP] 2 9 [/SUP], Michael E Farkouh[SUP] 7 10 [/SUP], Andrea S Gershon[SUP] 2 4 5 9 [/SUP], Clare L Atzema[SUP] 2 4 5 9 [/SUP], Jeffrey C Kwong[SUP] 2 11 12 13 14 [/SUP], Andrew Ha[SUP] 7 8 [/SUP], Vladimír Džavík[SUP] 7 [/SUP], Jacob A Udell[SUP] 15 4 7 9 16 [/SUP]
Affiliations
Introduction: People with type 2 diabetes (T2DM) have an elevated risk of adverse outcomes from COVID-19. Dipeptidyl peptidase-4 inhibitors (DPP4is) and glucagon-like peptide-1 receptor agonists (GLP1RAs) might have favorable effects on COVID-19 outcomes.
Research design and methods: We conducted a population-based cohort study in Ontario, Canada. We compared the risk of both COVID-19 infection as well as adverse outcomes between users of DPP4i or GLP1RA and users of sodium-glucose cotransporter-2 inhibitors (SGLT2is) or sulfonylureas (SUs). The study population was persons ≥66 years with T2DM taking metformin who had ≥1 COVID-19 PCR test between January 2020 and July 2021. We compared (1) COVID-19 infection and (2) adverse outcomes at 30 days among COVID-19 positive patients (major cardiovascular (CV) events, hospitalizations, intensive care unit admission, all-cause mortality, venous thromboembolism, mechanical ventilation). We reported weighted risk differences (RDs) and relative risks (RRs).
Results: There were 26,485 DPP4i/GLP1RA users (mean age 76, 47% female, 91% DPP4i users) and 14,487 SGLT2i/SU users (mean age 75, 39% female, 65% SGLT2i users). The weighted rate of COVID-19 infection in DPP4i/GLP1RA users was 10.3% compared with 10.4% among SGLT2i/SU users (weighted RD -0.06, 95% CI -0.79 to 0.66; RR 0.99, 95% CI 0.93 to 1.07). Among COVID-19 positive patients, the weighted RD for all-cause hospitalization for DPP4i/GLP1RA users versus SGLT2i/SU users was -6.72% (95% CI -3.02 to -10.4) and the adjusted weighted RR was 0.79 (95% CI 0.70 to 0.89). For major CV events, the weighted RD was -1.91% (95% CI -4.00 to 0.18) and RR 0.73 (95% CI 0.54 to 1.00).
Conclusions: DPP4i/GLP1RA use was not associated with reduced risk of COVID-19 infection compared with SGLT2i/SU use. DPP4i/GLP1RA use was associated with reduced risk of 30-day hospitalization among COVID-19 positive older adults and a possible trend towards a lower associated risk of CV events.
Keywords: COVID-19; Diabetes Mellitus, Type 2; Pharmacoepidemiology.
. 2025 Aug 7;13(4):e004677.
doi: 10.1136/bmjdrc-2024-004677. Association between dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists and COVID-19 infection and adverse outcomes: a cohort study
Wade Thompson[SUP] 1 2 3 [/SUP], Bing Yu[SUP] 2 [/SUP], Joan Porter[SUP] 2 [/SUP], Jiming Fang[SUP] 2 [/SUP], Laura E Ferreira-Legere[SUP] 2 [/SUP], Peter C Austin[SUP] 2 4 5 [/SUP], Cynthia A Jackevicius[SUP] 2 4 6 [/SUP], Heather Ross[SUP] 7 8 [/SUP], Douglas S Lee[SUP] 2 4 7 9 [/SUP], Alanna Weisman[SUP] 2 9 [/SUP], Michael E Farkouh[SUP] 7 10 [/SUP], Andrea S Gershon[SUP] 2 4 5 9 [/SUP], Clare L Atzema[SUP] 2 4 5 9 [/SUP], Jeffrey C Kwong[SUP] 2 11 12 13 14 [/SUP], Andrew Ha[SUP] 7 8 [/SUP], Vladimír Džavík[SUP] 7 [/SUP], Jacob A Udell[SUP] 15 4 7 9 16 [/SUP]
Affiliations
- PMID: 40780839
- DOI: 10.1136/bmjdrc-2024-004677
Introduction: People with type 2 diabetes (T2DM) have an elevated risk of adverse outcomes from COVID-19. Dipeptidyl peptidase-4 inhibitors (DPP4is) and glucagon-like peptide-1 receptor agonists (GLP1RAs) might have favorable effects on COVID-19 outcomes.
Research design and methods: We conducted a population-based cohort study in Ontario, Canada. We compared the risk of both COVID-19 infection as well as adverse outcomes between users of DPP4i or GLP1RA and users of sodium-glucose cotransporter-2 inhibitors (SGLT2is) or sulfonylureas (SUs). The study population was persons ≥66 years with T2DM taking metformin who had ≥1 COVID-19 PCR test between January 2020 and July 2021. We compared (1) COVID-19 infection and (2) adverse outcomes at 30 days among COVID-19 positive patients (major cardiovascular (CV) events, hospitalizations, intensive care unit admission, all-cause mortality, venous thromboembolism, mechanical ventilation). We reported weighted risk differences (RDs) and relative risks (RRs).
Results: There were 26,485 DPP4i/GLP1RA users (mean age 76, 47% female, 91% DPP4i users) and 14,487 SGLT2i/SU users (mean age 75, 39% female, 65% SGLT2i users). The weighted rate of COVID-19 infection in DPP4i/GLP1RA users was 10.3% compared with 10.4% among SGLT2i/SU users (weighted RD -0.06, 95% CI -0.79 to 0.66; RR 0.99, 95% CI 0.93 to 1.07). Among COVID-19 positive patients, the weighted RD for all-cause hospitalization for DPP4i/GLP1RA users versus SGLT2i/SU users was -6.72% (95% CI -3.02 to -10.4) and the adjusted weighted RR was 0.79 (95% CI 0.70 to 0.89). For major CV events, the weighted RD was -1.91% (95% CI -4.00 to 0.18) and RR 0.73 (95% CI 0.54 to 1.00).
Conclusions: DPP4i/GLP1RA use was not associated with reduced risk of COVID-19 infection compared with SGLT2i/SU use. DPP4i/GLP1RA use was associated with reduced risk of 30-day hospitalization among COVID-19 positive older adults and a possible trend towards a lower associated risk of CV events.
Keywords: COVID-19; Diabetes Mellitus, Type 2; Pharmacoepidemiology.