1. Hepatic and cardiovascular safety of acarbose among type 2 diabetes patients with end-stage renal disease: A nationwide population-based longitudinal study.
- Author
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Lin, Wei-Hung, Yang, Chen-Yi, Kuo, Shihchen, Kuo, Te-Hui, Roan, Jun-Neng, Li, Chung-Yi, Wang, Ming-Cheng, and Ou, Huang-Tz
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CHRONIC kidney failure , *TYPE 2 diabetes , *ACARBOSE , *PEOPLE with diabetes , *LONGITUDINAL method , *GLYCOSIDASES , *PHARMACODYNAMICS , *CHEMICAL inhibitors - Abstract
Aim: To assess the relationship between acarbose and hepatotoxicity, cardiovascular disease (CVD), and mortality among type 2 diabetes (T2D) patients with end-stage renal disease (ESRD).Methods: 32,531 T2D patients with ESRD were identified from Taiwan's National Health Insurance Research Database in 2000~∼2012 and followed up until 2013. 19.3% of subjects were newly initiated with acarbose during the follow-up. The use of acarbose was quantified as the numbers of the 30-day drug's supplies and dosages (measured by defined daily doses; DDDs), respectively. Time-varying Cox models were applied to evaluate the association of acarbose use with hepatic, cardiovascular and mortality outcomes, with adjustment for patients' demographics, comorbidities, diabetes severity, and co-medications.Results: For each 30-day supply increase in acarbose exposure, the risks of hepatic injury, composite CVD events, and all-cause mortality were significantly lowered by 9% (95% confidence interval: 6-12%), 7% (6-7%) and 7% (7-8%), respectively, while for each 30-day DDD increase in acarbose exposure, the risks for three aforementioned outcomes were significantly reduced by 45% (33-54%), 33% (29-36%) and 35% (32-39%), respectively. In subgroup analyses, the favorable study outcomes of acarbose use were more apparent among patients with more severe diabetes, a longer diabetes duration, or absence of established CVD at baseline.Conclusion: Acarbose used in real-world T2D patients with ESRD may have hepatic and cardiovascular safety. [ABSTRACT FROM AUTHOR]- Published
- 2021
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