Key points Is the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors versus glucagon-like peptide-1 receptor agonists (GLP-1 RA) associated with dry eye disease in adults with type 2 diabetes (T2D)? Findings In this cohort study in Taiwan that included 10,038 patients with type 2 diabetes who recently received SGLT2 inhibitors, there was a significant risk reduction in the incidence of dry eye diseases compared with 1,077 propensity score-weighted patients with diabetes type 2 who recently received GLP-1 RA. The lower incidence of dry eye disease with the use of SGLT2 inhibitors was consistent across different subgroups and sensitivity analyses. Meaning The findings of this study suggest that T2D patients newly receiving SGLT2 inhibitors may experience a lower risk of dry eye disease compared to those receiving GLP-1 RA. Importance Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been found to improve low-grade tissue and systemic inflammation; however, the association between the use of SGLT2 inhibitors and the incidence of dry eye disease (DED) has not been explored. |
Aim
To investigate the association between the use of SGLT2 inhibitors and dry eye disease in patients with type 2 diabetes (T2D).
Design, environment and participants
A retrospective cohort analysis of the largest multi-institutional electronic medical records database in Taiwan was performed to identify patients with type 2 diabetes who recently received SGLT2 inhibitors or glucagon-like peptide-1 (GLP-1) receptor agonists. RA) from 2016 to 2018 Data analysis was conducted from March 1 to May 31, 2022. Propensity scores with inverse probability of treatment weighting were generated to allow for homogeneous comparisons between the 2 groups.
Exhibitions
Treatment with SGLT2 inhibitors or GLP-1 RA.
Main results and measures
Incidence of dry eye disease, which was defined by clinical diagnoses, plus related drug prescription. Cox proportional hazards regression models were used to estimate hazard ratios with 95% CIs for the risk of DED.
Results
A total of 10,038 and 1077 patients with type 2 diabetes who recently received SGLT2 inhibitors (mean [SD] age, 59.5 [12.1] years; 5689 [56.7%] men) or GLP-1 RA (age mean [SD], 58.5 [SD] years; 587 [54.5%] men), respectively, were included in the analysis. The incidence of DED was lower in patients who recently received SGLT2 inhibitors (9.0 events per 1000 person-years) compared to those who received GLP-1 RA (11.5 events per 1000 person-years), which yielded a hazard ratio of 0.78 (95% CI, 0.68-0.89).
Subgroup analyzes indicated that the reduced risks of DED associated with SGLT2 inhibitors in patients with T2D were similar in different groups of age, sex, blood glucose level, and renal function.
The results of the sensitivity analyzes (including the propensity score matching approach, during-treatment analyses, and different follow-up periods of 1, 2, and 3 years) were similar to the main analyses.
Conclusions and relevance The findings of this study suggest that patients with type 2 diabetes newly receiving SGLT2 inhibitors may have a lower risk of DED compared to those receiving GLP-1 RAs. Prospective studies are needed to analyze these results. |
