Anti-Diabetes Medications for People with Immune-Mediated Inflammatory Disease: Real-World Data on Heart Health and Survival
Scientific Study Title:
Mortality and major adverse cardiovascular events after glucagon-like peptide-1 receptor agonist initiation in patients with immune-mediated inflammatory diseases and type 2 diabetes: A population-based study
Study Timeline
This study used administrative data from British Columbia spanning between January 2010 and December 2021
Why Did We Do This Research?
People with immune-mediated inflammatory diseases (IMIDs) like rheumatoid arthritis, psoriasis, and ankylosing spondylitis have a higher risk of heart problems and early death. Cardiac risk factors like type 2 diabetes and obesity, which involve ongoing low-level inflammation, can make these diseases worse and increase cardiovascular risk.
We wanted to find out if a group of anti-diabetes medications called GLP-1 receptor agonists (GLP-1-RAs) – like semaglutide, also known as Ozempic, is better than another group called DPP-4 inhibitors (DPP-4is) – like linagliptin, also known as Tradjenta, for people with certain immune-mediated inflammatory diseases who also have type 2 diabetes. Specifically, we wanted to know the impact of these medications on the risk of dying from any cause or having major heart problems.
What Did We Do?
We looked at health records from British Columbia to find people who had both immune-mediated inflammatory diseases and type 2 diabetes who started taking either GLP-1-RAs or DPP-4is between 2010 and 2021. We then compared the rates of death and major heart issues between those taking GLP-1-RAs and those taking DPP-4is. We also did a similar analysis for people without immune-mediated inflammatory diseases.
What Did We Find?
People taking GLP-1-RAs had a lower risk of dying from any cause and experiencing major heart problems compared to those taking DPP-4is. The difference was noticeable in both groups: those with immune-mediated inflammatory diseases and those without. This suggests that GLP-1-RAs might be a better option for reducing these risks in people with both immune-mediated inflammatory diseases and type 2 diabetes.
What Are the Next Steps?
We are now looking into whether GLP-1-RAs affect the risk of developing an autoimmune rheumatic disease in people with type 2 diabetes.
Research Team
Derin Karacabeyli, MD, MSc Student, Arthritis Research Canada Trainee (University of British Columbia)
Diane Lacaille, MDCM, MHSc, FRCPC, Scientific Director, Arthritis Research Canada (University of British Columbia)
Na Lu, MPH, Statistician, Arthritis Research Canada
Natalie McCormick, BSc, MSc, PhD, Postdoctoral fellow, Arthritis Research Canada Trainee (Massachusetts General Hospital and Harvard Medical School)
Hui Xie, BSc, MS, PhD, Senior Scientist, Arthritis Research Canada, (Simon Fraser University)
Hyon K Choi, MD, DrPH, FRCPC, Research Scientist, Arthritis Research Canada, (Massachusetts General Hospital and Harvard Medical School)
J. Antonio Aviña-Zubieta, MD, MSc, PhD, FRCPC, Senior Scientist, Arthritis Research Canada (University of British Columbia)
Who Funded This Research?
This work was supported by Preventing Complications from Inflammatory Skin, Joint and Bowel Conditions (PRECISION), a team grant funded by the Canadian Institutes of Health Research.
Related Publications:
- Karacabeyli D, Lacaille D, Lu N, McCormick N, Xie H, Choi HK, Aviña-Zubieta JA. Mortality and major adverse cardiovascular events after glucagon-like peptide-1 receptor agonist initiation in patients with immune-mediated inflammatory diseases and type 2 diabetes: A population-based study. PLoS One. 2024 Aug 8;19(8):e0308533. doi: 10.1371/journal.pone.0308533. PMID: 39116084; PMCID: PMC11309412.
