Preadmission GLP-1 Receptor Agonist Plus SGLT2 Inhibitor Use and Early Outcomes After Pneumonia Hospitalization in Adults With Type 2 Diabetes: A Target Trial Emulation
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 71,775
- 试验地点
- 1
- 主要终点
- Composite outcome (all-cause mortality, invasive mechanical ventilation, or renal replacement therapy)
研究概览
简要总结
This retrospective observational target-trial emulation uses electronic health record data from the TriNetX US Collaborative Network to compare preadmission glucose-lowering treatment strategies in adults with type 2 diabetes hospitalized with pneumonia. Time zero is the date of the index pneumonia admission. The study compares patients with evidence of prescriptions for both a GLP-1 receptor agonist and an SGLT2 inhibitor in the year before admission with patients prescribed a GLP-1 receptor agonist alone, an SGLT2 inhibitor alone, or usual care. Usual care includes metformin, sulfonylureas, or DPP-4 inhibitors without either study class. The primary outcome is a composite of all-cause death, invasive mechanical ventilation, or renal replacement therapy within 30 days of admission, with the individual components and 12-month mortality, major adverse cardiovascular events, and major adverse kidney events also evaluated. Propensity-score methods are used to reduce bias from nonrandom treatment selection.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults aged 18 years or older.
- •Type 2 diabetes mellitus
- •Hospitalization with pneumonia during the study period, serving as the index admission
- •Prescription of a GLP-1 receptor agonist, an SGLT2 inhibitor, or usual-care glucose-lowering therapy in the year before the index admission
- •No GLP-1 receptor agonist or SGLT2 inhibitor prescription in the 6 months before the first qualifying prescription
排除标准
- •Type 1 diabetes mellitus, or other specified diabetes types that are not type 2 diabetes
- •Human immunodeficiency virus infection
- •Bariatric surgery
- •Solid-organ transplantation
- •Pneumonia hospitalization, invasive mechanical ventilation, or renal replacement therapy in the year before the index admission
- •End-stage kidney disease, dialysis dependence, ventilator dependence, or tracheostomy status
- •Metastatic malignancy, lung cancer, or palliative care
- •Viral pneumonia, influenza with pneumonia, or COVID-19 around the index admission
- •Acute cardiovascular event in the 6 months before the index admission
结局指标
主要结局
Composite outcome (all-cause mortality, invasive mechanical ventilation, or renal replacement therapy)
时间窗: Within 30 days after the index pneumonia admission
次要结局
- All-cause mortality(Within 30 days after the index pneumonia admission)
- Invasive mechanical ventilation(Within 30 days after the index pneumonia admission)
- Renal replacement therapy(Within 30 days after the index pneumonia admission)
- Composite outcome (all-cause mortality, major adverse cardiovascular events, or major adverse kidney events)(Through 12 months after the index pneumonia admission)
- All-cause mortality(Through 12 months after the index pneumonia admission)
- Major adverse cardiovascular events(Through 12 months after the index pneumonia admission)
- Major adverse kidney events(Through 12 months after the index pneumonia admission)
研究者
Yu-Nan Huang
Assistant Professor/Research Fellow
Chung Shan Medical University