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Reason For 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.
Execution of Research
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.
Involvement
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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.
We are now looking into whether GLP-1-RAs affect the risk of developing an autoimmune rheumatic disease in people with type 2 diabetes.