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Table 4 Crude and adjusted ORs of severe COPD exacerbation associated with use of oral hypoglycemic agents at different daily dose among current users

From: Use of antidiabetic medications and risk of chronic obstructive pulmonary disease exacerbation requiring hospitalization: a disease risk score-matched nested case–control study

 

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

  1. 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
  2. a Adjusted for all covariates with standardized difference > 0.1 in Table 1
  3. 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
  4. c Current use was defined as the end date of the most recent prescription within the 30 days prior to the index date
  5. d p < 0.05
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Respiratory Research

ISSN: 1465-993X

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