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

Table 6 Crude and adjusted ORs of severe COPD exacerbation associated with dual or more therapies of oral hypoglycemic agents

	Cases (n = 2700)	Controls (n = 9272)	Crude OR (95% CI)	Adjusted OR^a (95% CI)
Current use of dual or more therapy, no (%)^b
Metformin + sulfonylureas	460 (17.0)	2,238 (24.1)	0.71 (0.59–0.86)^c	0.78 (0.64–0.95)^c
Metformin + α-glucosidase inhibitors	12 (0.4)	51 (0.6)	1.10 (0.57–2.09)	0.93 (0.47–1.81)
Metformin + TZDs	5 (0.2)	33 (0.4)	0.62 (0.24–1.63)	0.71 (0.27–1.88)
Metformin + DPP-4 inhibitors	22 (0.8)	76 (0.8)	1.25 (0.77–2.05)	1.30 (0.78–2.16)
Metformin + meglitinides	46 (1.7)	132 (1.4)	1.52 (1.07–2.16)^c	1.32 (0.91–1.91)
Other combinations of dual therapy	118 (4.4)	402 (4.3)	1.36 (1.08–1.71)^c	1.27 (0.997–1.61)
All triple therapy	235 (8.7)	960 (10.4)	1.07 (0.91–1.27)	1.12 (0.94–1.34)
Metformin-contained triple therapy	214 (7.9)	882 (9.5)	1.08 (0.90–1.28)	1.13 (0.94–1.35)
Other triple therapy	21 (0.8)	78 (0.8)	1.10 (0.67–1.81)	1.09 (0.65–1.84)
Other types of dual or more therapy^d			Reference	Reference

OR, odds ratio; COPD, chronic obstructive pulmonary disease; CI confidence interval; No., Number; TZD, thiazolidinedione; DPP-4, dipeptidyl peptidase-4
^a Adjusted for all covariates with standardized difference > 0.1 in Table 1
^b Current use was defined as the end date of the most recent prescription within the 30 days prior to the index date
^c p < 0.05
^d Each of the dual or more therapy of antidiabetic agents was separately compared with all of the other types of dual or more therapy of antidiabetic agents combined

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