Table 4.
Crude and adjusted ORs of severe COPD exacerbation associated with use of oral hypoglycemic agents at different daily dose among current users
| Cases (n = 2700) | Controls (n = 9272) | OR (95% CI) | |||
|---|---|---|---|---|---|
| Crude OR | Model 1 Adjusted ORa |
Model 2 Adjusted ORb |
|||
| Current use, no (%)c | |||||
| Metformin | |||||
| ≤ 0.5 DDD | 649 (24.0) | 2811 (30.3) | 0.73 (0.65–0.82)d | 0.78 (0.69–0.88)d | 0.81 (0.71–0.92)d |
| 0.51–1 DDD | 391 (14.5) | 1601 (17.3) | 0.78 (0.67–0.89)d | 0.85 (0.73–0.98)d | 0.89 (0.76–1.04) |
| > 1 DDD | 65 (2.4) | 242 (2.6) | 0.86 (0.64–1.15) | 1.05 (0.78–1.42) | 1.10 (0.81–1.50) |
| Non-metformin | 741 (27.4) | 2348 (25.3) | Reference | Reference | Reference |
| P for trend | 0.002 | 0.084 | 0.358 | ||
| Sulfonylureas | |||||
| ≤ 0.5 DDD | 325 (12.0) | 1170 (12.6) | 0.92 (0.79–1.07) | 0.97 (0.82–1.13) | 1.00 (0.85–1.18) |
| 0.51–1 DDD | 389 (14.4) | 1481 (16.0) | 0.90 (0.78–1.04) | 1.00 (0.86–1.16) | 1.05 (0.90–1.23) |
| > 1 DDD | 467 (17.3) | 2121 (22.9) | 0.73 (0.64–0.84)d | 0.85 (0.74–0.98)d | 0.90 (0.77–1.04) |
| Non-sulfonylureas | 665 (24.6) | 2230 (24.1) | Reference | Reference | Reference |
| P for trend | < 0.001 | 0.177 | 0.607 | ||
| Current use, no (%)c | |||||
| α-Glucosidase inhibitors | |||||
| ≤ 0.5 DDD | 159 (5.9) | 649 (7.0) | 0.93 (0.77–1.12) | 0.93 (0.77–1.13) | 0.94 (0.77–1.15) |
| 0.51–1 DDD | 37 (1.4) | 120 (1.3) | 1.09 (0.74–1.59) | 1.17 (0.78–1.75) | 1.17 (0.78–1.77) |
| > 1 DDD | 3 (0.1) | 5 (0.1) | 1.80 (0.41–7.93) | 1.73 (0.37–8.18) | 1.73 (0.36–8.19) |
| Non-α-glucosidase inhibitors | 1647 (61.0) | 6228 (67.2) | Reference | Reference | Reference |
| P for trend | 0.837 | 0.550 | 0.550 | ||
| TZDs | |||||
| ≤ 0.5 DDD | 22 (0.8) | 126 (1.4) | 0.63 (0.39–0.998)d | 0.64 (0.40–1.04) | 0.65 (0.40–1.05) |
| 0.51–1 DDD | 93 (3.4) | 397 (4.3) | 0.89 (0.70–1.12) | 0.98 (0.76–1.25) | 0.97 (0.75–1.26) |
| > 1 DDD | 8 (0.3) | 43 (0.5) | 0.65 (0.30–1.40) | 0.67 (0.29–1.55) | 0.66 (0.28–1.55) |
| Non-TZDs | 1723 (63.8) | 6436 (69.4) | Reference | Reference | Reference |
| P for trend | 0.217 | 0.816 | 0.818 | ||
| Current use, no (%)c | |||||
| DPP-4 inhibitors | |||||
| ≤ 0.5 DDD | 50 (1.9) | 180 (1.9) | 1.07 (0.77–1.50) | 1.05 (0.74–1.48) | 1.07 (0.75–1.53) |
| 0.51–1 DDD | 117 (4.3) | 431 (4.7) | 1.03 (0.82–1.29) | 1.09 (0.86–1.38) | 1.14 (0.89–1.46) |
| > 1 DDD | 14 (0.5) | 34 (0.4) | 1.58 (0.82–3.06) | 1.36 (0.68–2.71) | 1.43 (0.71–2.85) |
| Non-DPP-4 inhibitors | 1665 (61.7) | 6357 (68.6) | Reference | Reference | Reference |
| P for trend | 0.497 | 0.568 | 0.471 | ||
| Meglitinides | |||||
| ≤ 0.5 DDD | 86 (3.2) | 238 (2.6) | 1.37 (1.06–1.77)d | 1.06 (0.81–1.39) | 1.05 (0.80–1.38) |
| 0.51–1 DDD | 116 (4.3) | 286 (3.1) | 1.59 (1.27–2.00)d | 1.34 (1.05–1.70)d | 1.35 (1.06–1.71)d |
| > 1 DDD | 39 (1.4) | 127 (1.4) | 1.24 (0.86–1.78) | 1.07 (0.73–1.57) | 1.10 (0.75–1.62) |
| Non-meglitinides | 1605 (59.4) | 6351 (68.5) | Reference | Reference | Reference |
| P for trend | < 0.001 | 0.077 | 0.065 | ||
OR, odds ratio; COPD, chronic obstructive pulmonary disease; CI confidence interval; No., Number; DDD, defined daily dose; TZD, thiazolidinedione; DPP-4, dipeptidyl peptidase-4; DM, diabetic mellitus
a Adjusted for all covariates with standardized difference > 0.1 in Table 1
b Adjusted for all covariates with standardized difference > 0.1 in Table 1 and DM therapy regimen in the 180 days prior to the index date
c Current use was defined as the end date of the most recent prescription within the 30 days prior to the index date
d p < 0.05