Key result
DPP-4 inhibitors linked to ~53% lower all-cause mortality vs nonuse in COPD and T2D.
Why the study?
COPD is frequently associated with type 2 diabetes and cardiovascular disease, but few studies have evaluated the impact of antidiabetic drugs, including DPP-4 inhibitors, in patients with both conditions.
Does DPP-4 inhibitor use reduce mortality, cardiovascular events, and respiratory complications in patients with COPD and T2D?
Cohort (n=111,848)
Yes
Does DPP-4 inhibitor use reduce mortality, cardiovascular events, and respiratory complications in patients with COPD and T2D?
Effect estimate: HR 0.47 (95% CI 0.45-0.49)
Absolute Event Rate: 21.58% vs 40.26%
p-value: p=<0.001
DPP-4 inhibitor use was associated with lower mortality in COPD and T2D; hypothesis-generating and leaves open causality pending randomized confirmation.
Aims: COPD is a comorbid condition often associated with type 2 diabetes (T2D) and cardiovascular diseases, but few studies have observed the impact of various antidiabetic drugs in patients with COPD and T2D. We conducted this study to investigate the long-term outcomes of dipeptidyl peptidase-4 (DPP-4) inhibitor use in patients with COPD and T2D. Materials and methods: We recruited 55 924 pairs of propensity score-matched DPP-4 inhibitor users and nonusers from Taiwan's National Health Insurance Research Database between 1 January 2008 and 31 December 2020. We used the Cox proportional hazards models with robust sandwich se estimates to compare the risks of all-cause mortality, major adverse cardiovascular events (MACEs) and respiratory outcomes in participants with COPD and T2D. Results: Compared with no use of DPP-4 inhibitors, the adjusted hazard ratios (aHRs) (95% confidence interval (CI)) for DPP-4 inhibitor use for all-cause mortality, MACEs, hospitalisation for COPD, invasive mechanical ventilation, bacterial pneumonia and lung cancer were 0.47 (0.45-0.49), 0.92 (0.88-0.95), 0.73 (0.62-0.85), 0.76 (0.71-0.82), 0.73 (0.70-0.76) and 0.74 (0.71-0.78), respectively. DPP-4 inhibitor users also exhibited a significantly lower cumulative incidence of hospitalisation for COPD (log-rank test, p=0.004), mechanical ventilation (log-rank test, p<0.001), lung cancer (log-rank test, p<0.001), bacterial pneumonia (log-rank test, p<0.001) and mortality (log-rank test, p<0.001) than nonusers. Conclusions: This nationwide cohort study showed that DPP-4 inhibitor use was associated with a significantly lower risk of mortality, cardiovascular events, respiratory complications and lung cancer in patients with COPD and T2D. Patients with COPD may benefit from DPP-4 inhibitors.
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Yen et al. (2025) conducted a cohort in COPD and Type 2 Diabetes (n=111,848). DPP-4 inhibitors vs. No DPP-4 inhibitors was evaluated on All-cause mortality (HR 0.47, 95% CI 0.45-0.49, p=<0.001). DPP-4 inhibitor use in patients with COPD and type 2 diabetes was associated with a 53% lower risk of all-cause mortality (HR 0.47) compared to nonuse.
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