Table 3.
IRRs of COPD Exacerbations and the Association with Glucagon-like Peptide 1 Receptor Agonists or Comparator Treatments, Inclusive of Recent Exacerbation* History
| Drug Exposure | Clinical Model† |
Metabolic Model† |
Exploratory Analysis, Changes in HbA1c and BMI‡ |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|
| IRR | 95% CI | P Value | IRR | 95% CI | P Value | IRR | 95% CI | P Value | ||
| Moderate and severe COPD exacerbations | DPP-4is | 1.22 | 0.90–1.65 | 0.21 | 1.13 | 0.83–1.55 | 0.44 | 2.01 | 1.00–4.15 | 0.057 |
| SGLT2is | 0.94 | 0.70–1.26 | 0.67 | 0.89 | 0.66–1.20 | 0.44 | 1.67 | 0.85–3.27 | 0.13 | |
| Sulfonylureas | 1.59 | 1.25–2.03 | 0.0002 | 1.49 | 1.16–1.93 | 0.002 | 2.57 | 1.34–4.94 | 0.005 | |
| GLP-1RAs (ref) | — | — | — | — | — | — | — | — | — | |
Definition of abbreviations: BMI = body mass index; CI = confidence interval; COPD = chronic obstructive pulmonary disease; DPP-4i = dipeptidyl peptidase 4 inhibitor; GLP-1RA = glucagon-like peptide 1 receptor agonists; IRR = incidence rate ratio; ref = reference group; SGLT2i = sodium-glucose cotransporter 2 inhibitor.
Defined as ⩽12 months from index date.
The clinical model was adjusted for age; sex; race; Elixhauser Comorbidity Index; two-year health system encounter history; season of initiation; smoking history; number of exacerbations in the prior year; concurrent metformin use; and concurrent short-acting β-agonist, short-acting muscarinic antagonist, long-acting β-agonist, long-acting muscarinic antagonist, or triple-therapy use. The metabolic model was also adjusted for baseline HbA1c and baseline BMI.
To estimate the direct controlled effect, the exploratory analysis was also adjusted for change in BMI and change in HbA1c during the six-month study period.