(276) Use of Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) and Risk of Parkinson's Disease

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 607

Presenting Author(s)

Miyuki Hsing-Chun Hsieh
– NCKU Institute of Clinical Pharmacy and Pharmaceutical Sciences, Chiayi City, Taiwan

Co-Author(s)

Edward Lai, PhD
– Associate Professor, National Cheng Kung University, National Cheng Kung University, Tainan City, Tainan, Taiwan (Republic of China)

Background: Previous study detected unknown safety signal of Parkinson’s disease for SGLT2 inhibitors, and further studies for signal strengthen and refinement was required.

Objectives: To investigate whether use of SGLT2i was associated with risk of developing Parkinson’s disease.

Methods: In this cohort study, we identified initiators of SGLT2is with age ≥40 during 2016 to 2018 from the National Health Insurance Database in Taiwan. Other patients treated with dipeptidyl peptidase-4 inhibitors (DPP4i) during the same period served as active comparator group. Their first prescription date of SGLT2i or DPP4i was defined as index date. We further excluded those who had been diagnosed with Parkinson’s disease before index date. All patients were followed from index date until incident diagnosis of Parkinson’s disease, death, or end of study period (December 31, 2018). We illustrated survival curves of the outcome using Kaplan-Meier method and applied Cox regression with cause-specific model to generate hazard ratios between SGLT2i and DPP4i groups given competing risk of death.

Results: 200,022 SGLT2i users and 772,335 DPP4i users were identified. The median age was 64 and 53% were male. After mean follow up of 1.9 years, we observed 514 and 6,517 cases of Parkinson’s disease from SGLT2i and DPP4i group, respectively, resulted in incidence rate of 2.01 and 4.04 per thousand patient-year. After considered for competing risk of death and adjusted for age and sex, use of SGLT2i was associated with lower risk of Parkinson’s disease when compared with DPP4i (odds ratio 0.80; 95% confidence interval 0.73 to 0.88).

Conclusions: Compared to DPP4i, use of SGLT2i may decrease risk of incident Parkinson’s disease. Further studies with more complete confounding adjustment and longer follow up are warranted.