The role of novel antihyperglycaemic drugs in cardiology and diabetes is well recognised, and laboratory studies have suggested possible mechanisms by which these drugs could reduce chronic obstructive pulmonary disease (COPD) exacerbations in patients with type 2 diabetes mellitus. A population-based cohort study by Pradhan et al ( BMJ 2022;379:e071380) used primary care and hospital databases to compare 3 novel antihyperglycaemic drugs (glucagon-like peptide 1 (GLP-1) receptor agonists, n=1252; dipeptidyl peptidase 4 (DPP-4) inhibitors, n=8731 and sodium-glucose co-transporter-2 (SGLT2) inhibitors, n=2956) to sulphonylureas (n=14 259, 18 204 and 10 841, respectively, for each comparison). After adjustment for confounders, GLP-1 receptor agonists were associated with a 30% lower risk of a severe COPD exacerbations (3.5 vs 5.0 events per 100 person years; HR 0.70, 95% CI 0.49 to 0.99) and SGLT2 inhibitors were associated with a 38% decrease. (2.4 vs 3.9; HR 0.62, 95% CI 0.48 to 0.81). There was no significant difference between sulphonylureas and DPP4 inhibitors. The weight-inducing effects of sulphonylureas could have impacted their role as a comparator, and the use of a database relying on correct classification of illness could lead to inaccuracies. A randomised control trial will help to …

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期刊俱乐部

新型抗高血糖药物在心脏病学和糖尿病中的作用已得到充分认可，实验室研究表明这些药物可以减少 2 型糖尿病患者慢性阻塞性肺疾病 (COPD) 恶化的可能机制。Pradhan 等人进行的一项基于人群的队列研究 (BMJ 2022;379:e071380) 使用初级保健和医院数据库比较了 3 种新型抗高血糖药物（胰高血糖素样肽 1 (GLP-1) 受体激动剂，n=1252；二肽基肽酶4 (DPP-4) 抑制剂，n=8731 和钠-葡萄糖协同转运蛋白-2 (SGLT2) 抑制剂，n=2956) 至磺脲类药物（每次比较分别为 n=14259、18204 和 10841）。调整混杂因素后，GLP-1 受体激动剂可使 COPD 严重恶化的风险降低 30%（3.5 比 5. 每 100 人年 0 起事件；HR 0.70，95% CI 0.49 至 0.99）和 SGLT2 抑制剂与 38% 的降低相关。（2.4 对 3.9；HR 0.62，95% CI 0.48 至 0.81）。磺脲类药物和 DPP4 抑制剂之间没有显着差异。磺脲类药物的体重诱导作用可能会影响它们作为比较物的作用，并且使用依赖于正确疾病分类的数据库可能会导致不准确。随机对照试验将有助于…… 使用依赖于疾病正确分类的数据库可能会导致不准确。随机对照试验将有助于…… 使用依赖于疾病正确分类的数据库可能会导致不准确。随机对照试验将有助于……