Table 1.
Patient Characteristics
| Treatment Group |
P Value | ||||
|---|---|---|---|---|---|
| DPP-4is | GLP-1RAs | SGLT2is | Sulfonylureas | ||
| Patient count, n | 260 | 328 | 353 | 701 | — |
| Age, yr, median (IQR) | 72.9 (64.0 to 79.9) | 67.2 (60.8 to 73.7) | 72.0 (64.9 to 78.4) | 69.8 (63.8 to 76.6) | <0.0001 |
| Female sex, n (%) | 101 (38.9) | 139 (42.4) | 116 (32.9) | 285 (40.7) | 0.047 |
| Race, n (%)* | |||||
| Asian | 2 (0.77) | 1 (0.30) | 2 (0.57) | 9 (1.28) | 0.22 |
| Black | 17 (6.54) | 21 (6.4) | 27 (7.65) | 30 (4.28) | |
| White | 226 (86.92) | 283 (86.28) | 297 (84.14) | 629 (89.73) | |
| Other | 9 (3.46) | 15 (4.57) | 18 (4.25) | 21 (2.00) | |
| Unknown | 6 (2.31) | 8 (2.44) | 9 (2.55) | 12 (1.71) | |
| Ethnicity, n (%) | |||||
| Hispanic | 7 (2.69) | 4 (1.22) | 10 (2.83) | 11 (1.57) | 0.78 |
| Unknown | 20 (7.69) | 30 (9.15) | 31 (8.78) | 67 (9.56) | |
| Current smoking, n (%) | 69 (26.6) | 117 (35.7) | 134 (38.0) | 225 (32.1) | 0.09 |
| Past | 164 (63.3) | 178 (54.3) | 191 (54.1) | 415 (29.2) | |
| Never | 26 (10) | 33 (10) | 28 (7.9) | 61 (8.7) | |
| BMI, kg/m2, median (IQR) | |||||
| Baseline | 29.7 (25.9 to 34.5) | 34.9 (30.5 to 40.3) | 30.8 (27.2 to 35.3) | 30.7 (26.6 to 34.8) | <0.0001 |
| BMI change | −0.21 (−1.2 to 0.73) | −0.73 (−2.1 to 0.3) | −0.69 (−1.7 to 0.089) | 0 (−0.96 to 0.92) | <0.0001 |
| Elixhauser Comorbidity Index, median (IQR) | 6 (2 to 8) | 6 (4 to 9) | 8 (5 to 10) | 5 (2 to 7) | <0.0001 |
| Rheumatologic disease, n (%) | 12 (4.62) | 21 (6.40) | 27 (7.65) | 32 (4.56) | 0.16 |
| Health system encounters within 2 yr of index date, median (IQR) | 54 (9.5 to 132) | 106.5 (38 to 178.5) | 124 (59 to 205) | 29 (4 to 88) | <0.0001 |
| Year of drug initiation, median year (IQR) | 2017 (2015 to 2019) | 2019 (2017 to 2021) | 2021 (2019 to 2021) | 2016 (2013 to 2018) | <0.0001 |
| Season of initiation, flu season,† yes, n (%) | 141 (54.23) | 199 (60.67) | 222 (62.89) | 403 (57.49) | 0.13 |
| Exacerbations ⩽12 mo before index date, mean (SD) | 1.10 (2.15) | 1.13 (2.04) | 1.36 (2.32) | 1.24 (2.21) | 0.35 |
| FEV1 (% predicted), baseline, median (IQR) | 56 (45 to 69.5) | 57 (44 to 71) | 56 (45 to 70) | 55 (42 to 68) | 0.06 |
| GOLD grade, baseline, n, (%) | |||||
| 1 | 30 (12.3) | 43 (13.7) | 43 (12.9) | 79 (11.8) | 0.07 |
| 2 | 131 (53.7) | 165 (52.6) | 175 (52.6) | 334 (49.9) | — |
| 3 | 70 (28.7) | 94 (30) | 104 (31.2) | 199 (29.8) | — |
| 4 | 13 (5.3) | 12 (3.8) | 11 (3.3) | 57 (8.5) | — |
| COPD medications, baseline use, n (%) | |||||
| SABA | 175 (67.31) | 268 (81.71) | 285 (80.74) | 415 (59.20) | <0.0001 |
| SAMA | 103 (39.62) | 167 (50.91) | 179 (50.71) | 242 (34.52) | <0.0001 |
| LABA | 122 (46.92) | 184 (56.10) | 205 (58.07) | 275 (39.23) | <0.0001 |
| ICS–LABA | 114 (43.9) | 156 (47.6) | 178 (50.4) | 260 (37.1) | <0.0001 |
| LAMA | 128 (49.23) | 183 (55.79) | 222 (62.89) | 26 (37.23) | <0.0001 |
| ICS–LABA–LAMA | 5 (1.92) | 12 (3.66) | 20 (5.67) | 9 (1.28) | 0.0004 |
| Metformin, baseline use, n (%) | 124 (47.69) | 179 (54.57) | 179 (50.71) | 244 (34.81) | <0.0001 |
| HbA1c, mmol/mol, median (IQR) | |||||
| Baseline | 7.6 (6.6 to 8.7) | 7.6 (6.3 to 9.0) | 7.1 (6.2 to 8.4) | 7.4 (6.5 to 8.3) | 0.07 |
| Change | −0.4 (−1.3 to 0.2) | −0.5 (−1.3 to 0.1) | −0.2 (−1 to 0.3) | −0.6 (−1.5 to 0.2) | 0.11 |
| One or more severe exacerbations during the study period, n patients (%) | 39 (15) | 29 (8.84) | 43 (12.18) | 125 (17.83) | 0.0009 |
| One or more moderate exacerbation during the study period, n patients (%) | 71 (27.31) | 76 (23.17) | 85 (24.08) | 220 (31.38) | 0.015 |
Definition of abbreviations: BMI = body mass index; COPD = chronic obstructive pulmonary disease; DPP-4i = dipeptidyl peptidase 4 inhibitors; GLP-1RA = glucagon-like peptide 1 receptor agonist; GOLD = Global Initiative for Chronic Obstructive Lung Disease; IQR = interquartile range; LABA = long-acting β-agonist; LAMA = long-acting muscarinic antagonist; SABA = short-acting muscarinic antagonist; SABA = short-acting β-agonist; SGLT2i = sodium-glucose cotransporter 2 inhibitor.
Race category “other” includes the following electronic health record–defined options: other, American Indian or Alaska native (n = 1; SGLT2i), and Native Hawaiian or other Pacific Islander (n = 1; GLP-1RA). Race category “unknown” includes electronic health record–defined categories of unknown, declined, and Missing.
Defined as October 1 to April 31 on the basis of CDC data (33).