Active Surveillance Research Program for the Assessment of the Safety and the Effectiveness of Linagliptin

Sponsor
Boehringer Ingelheim (Industry)
Overall Status
Completed
CT.gov ID
NCT02197078
Collaborator
Eli Lilly and Company (Industry)
189,426
1
54.9
3448.4

Study Details

Study Description

Brief Summary

This protocol is for a series of comparative effectiveness and safety analyses within periodically updated cohorts of patients initiating linagliptin, other DPP-4 inhibitors, and other oral hypoglycemic medications, followed longitudinally for the occurrence of a variety of health outcomes. The primary analysis will be conducted among patients without prior within-class medication use.

Condition or Disease Intervention/Treatment Phase

    Study Design

    Study Type:
    Observational
    Actual Enrollment :
    189426 participants
    Observational Model:
    Cohort
    Time Perspective:
    Retrospective
    Official Title:
    Active Surveillance Research Program for the Assessment of the Safety and the Effectiveness of Linagliptin
    Actual Study Start Date :
    Jul 30, 2014
    Actual Primary Completion Date :
    Feb 26, 2019
    Actual Study Completion Date :
    Feb 26, 2019

    Arms and Interventions

    Arm Intervention/Treatment
    Glitazones

    Linagliptin

    Sulfonylurea

    Within-class comparators

    Outcome Measures

    Primary Outcome Measures

    1. Number of Participants With Major Adverse Cardiovascular Event [Up to 5 years and 7 months]

      Number of participants with major adverse cardiovascular event is presented by the number of patients reported a composite of: Coronary revascularization (elective and non-elective procedure) Acute coronary syndrome (ACS), including acute myocardial infarction (MI) Stroke (Ischemic and hemorrhagic stroke)

    2. Number of Participants With Coronary Revascularization [Up to 5 years and 7 month]

      Number of participants with coronary revascularization (elective and non-elective procedure)

    3. Number of Participants With Acute Coronary Syndrome [Up to 5 years and 7 months]

      Number of participants with acute coronary syndrome (ACS). The definition for ACS included acute myocardial infarction (MI), but acute MI was not assessed separately.

    4. Number of Participants With Stroke [Up to 5 years and 7 months]

      Number of participants with ischemic or hemorrhagic stroke. Both types of stroke were included in the definition for stroke, but were not assessed separately

    Secondary Outcome Measures

    1. Number of Participants With Heart Failure Hospitalization [Up to 5 years and 7 months]

      Number of participants with heart failure hospitalization

    2. Number of Participants With Incident End Stage Renal Disease [Up to 5 years and 7 months]

      Number of participants with incident end stage renal disease (ESRD)

    3. Number of Participants With Acute Renal Failure [Up to 5 years and 7 months]

      Number of participants with acute renal failure

    4. Number of Participants With Acute Renal Failure Requiring Dialysis [Up to 5 years and 7 months]

      Number of patients with acute renal failure requiring dialysis

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion criteria:
    • A dispensing of an oral hypoglycemic medication

    • A diagnosis of type 2 diabetes mellitus (T2DM)

    Exclusion criteria:
    • less than 18 years old

    • missing or ambiguous age or sex information

    • at least one diagnosis of type 1 diabetes mellitus

    • less than 6 months enrolment in the database preceding the date of the first dispensing

    • secondary diabetes

    • history of cancer

    • end-stage renal disease (ESRD)

    • HIV

    • organ transplant

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Brigham and Women's Hospital Boston Massachusetts United States 02120

    Sponsors and Collaborators

    • Boehringer Ingelheim
    • Eli Lilly and Company

    Investigators

    • Study Chair: Boehringer Ingelheim, Boehringer Ingelheim

    Study Documents (Full-Text)

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    Boehringer Ingelheim
    ClinicalTrials.gov Identifier:
    NCT02197078
    Other Study ID Numbers:
    • 1218.163
    First Posted:
    Jul 22, 2014
    Last Update Posted:
    Apr 2, 2020
    Last Verified:
    Mar 1, 2020
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details From Clinformatics and MarketScan source data, patients with a recorded diagnosis of type 2 diabetes mellitus (T2DM) who initiated linagliptin, sitagliptin, saxagliptin, alogliptin, pioglitazone, or 2nd generation sulfonylureas were identified between May 2011 and December 2016.
    Pre-assignment Detail Only participants with no use of a medication in the same class or comparator class during the 6 months prior to index date, who were at least 18 years of age and enrolled for a minimum of 6 months in the data source before treatment initiation were included.
    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database
    Period Title: Overall Study
    STARTED 14688 14688 10614 10614 9538 9538 25135 25135 18996 18996 15742 15742
    COMPLETED 14688 14688 10614 10614 9538 9538 25135 25135 18996 18996 15742 15742
    NOT COMPLETED 0 0 0 0 0 0 0 0 0 0 0 0

    Baseline Characteristics

    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan Total
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database Total of all reporting groups
    Overall Participants 14688 14688 10614 10614 9538 9538 25135 25135 18996 18996 15742 15742 189426
    Age (Years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [Years]
    56.31
    (12.45)
    56.30
    (12.35)
    56.53
    (12.48)
    56.77
    (12.54)
    55.03
    (12.18)
    55.00
    (12.21)
    55.25
    (11.26)
    55.27
    (11.36)
    54.71
    (11.22)
    54.73
    (11.28)
    54.41
    (11.28)
    54.40
    (11.31)
    55.39
    (11.83)
    Sex: Female, Male (Count of Participants)
    Female
    6118
    41.7%
    6098
    41.5%
    4266
    40.2%
    4337
    40.9%
    3985
    41.8%
    3968
    41.6%
    10377
    41.3%
    10309
    41%
    7805
    41.1%
    7850
    41.3%
    6527
    41.5%
    6582
    41.8%
    78222
    41.3%
    Male
    8570
    58.3%
    8590
    58.5%
    6348
    59.8%
    6277
    59.1%
    5553
    58.2%
    5570
    58.4%
    14758
    58.7%
    14826
    59%
    11191
    58.9%
    11146
    58.7%
    9215
    58.5%
    9160
    58.2%
    111204
    58.7%
    Race and Ethnicity Not Collected (Count of Participants)
    Count of Participants [Participants]
    0
    0%

    Outcome Measures

    1. Primary Outcome
    Title Number of Participants With Major Adverse Cardiovascular Event
    Description Number of participants with major adverse cardiovascular event is presented by the number of patients reported a composite of: Coronary revascularization (elective and non-elective procedure) Acute coronary syndrome (ACS), including acute myocardial infarction (MI) Stroke (Ischemic and hemorrhagic stroke)
    Time Frame Up to 5 years and 7 months

    Outcome Measure Data

    Analysis Population Description
    1:1 propensity score matched cohorts of linagliptin initiators and comparator groups initiators, identified from Clinformatics and MarketScan database between May 2011 and December 2016
    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database
    Measure Participants 14688 14688 10614 10614 9538 9538 25135 25135 18996 18996 15742 15742
    Number [Participants]
    165
    1.1%
    151
    1%
    120
    1.1%
    102
    1%
    127
    1.3%
    82
    0.9%
    403
    1.6%
    369
    1.5%
    262
    1.4%
    270
    1.4%
    259
    1.6%
    194
    1.2%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - Clinformatics, Linagliptin 1 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.82
    Confidence Interval (2-Sided) 95%
    0.66 to 1.03
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - Clinformatics, Linagliptin 2 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.85
    Confidence Interval (2-Sided) 95%
    0.65 to 1.10
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - Clinformatics, Linagliptin 3 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.65
    Confidence Interval (2-Sided) 95%
    0.49 to 0.86
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - MarketScan, Linagliptin 1 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.95
    Confidence Interval (2-Sided) 95%
    0.83 to 1.10
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - MarketScan, Linagliptin 2 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.01
    Confidence Interval (2-Sided) 95%
    0.85 to 1.19
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - MarketScan, Linagliptin 3 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.80
    Confidence Interval (2-Sided) 95%
    0.66 to 0.96
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    2. Primary Outcome
    Title Number of Participants With Coronary Revascularization
    Description Number of participants with coronary revascularization (elective and non-elective procedure)
    Time Frame Up to 5 years and 7 month

    Outcome Measure Data

    Analysis Population Description
    1:1 propensity score matched cohorts of linagliptin initiators and comparator groups initiators, identified from Clinformatics and MarketScan database between May 2011 and December 2016.
    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database
    Measure Participants 14688 14688 10614 10614 9538 9538 25135 25135 18996 18996 15742 15742
    Number [Participants]
    82
    0.6%
    81
    0.6%
    67
    0.6%
    54
    0.5%
    67
    0.7%
    46
    0.5%
    181
    0.7%
    181
    0.7%
    129
    0.7%
    133
    0.7%
    125
    0.8%
    94
    0.6%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - Clinformatics, Linagliptin 1 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.90
    Confidence Interval (2-Sided) 95%
    0.66 to 1.23
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - Clinformatics, Linagliptin 2 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.81
    Confidence Interval (2-Sided) 95%
    0.57 to 1.16
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - Clinformatics, Linagliptin 3 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.70
    Confidence Interval (2-Sided) 95%
    0.48 to 1.01
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - MarketScan, Linagliptin 1 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.04
    Confidence Interval (2-Sided) 95%
    0.85 to 1.28
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - MarketScan, Linagliptin 2 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.01
    Confidence Interval (2-Sided) 95%
    0.79 to 1.28
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - MarketScan, Linagliptin 3 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.81
    Confidence Interval (2-Sided) 95%
    0.62 to 1.06
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    3. Primary Outcome
    Title Number of Participants With Acute Coronary Syndrome
    Description Number of participants with acute coronary syndrome (ACS). The definition for ACS included acute myocardial infarction (MI), but acute MI was not assessed separately.
    Time Frame Up to 5 years and 7 months

    Outcome Measure Data

    Analysis Population Description
    1:1 propensity score matched cohorts of linagliptin initiators and comparator groups initiators, identified from Clinformatics and MarketScan database between May 2011 and December 2016.
    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database
    Measure Participants 14688 14688 10614 10614 9538 9538 25135 25135 18996 18996 15742 15742
    Number [Participants]
    93
    0.6%
    72
    0.5%
    76
    0.7%
    48
    0.5%
    72
    0.8%
    43
    0.5%
    238
    0.9%
    221
    0.9%
    163
    0.9%
    160
    0.8%
    161
    1%
    115
    0.7%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - Clinformatics, Linagliptin 1 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.69
    Confidence Interval (2-Sided) 95%
    0.51 to 0.94
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - Clinformatics, Linagliptin 2 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.63
    Confidence Interval (2-Sided) 95%
    0.44 to 0.90
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - Clinformatics, Linagliptin 3 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.60
    Confidence Interval (2-Sided) 95%
    0.41 to 0.88
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - MarketScan, Linagliptin 1 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.97
    Confidence Interval (2-Sided) 95%
    0.81 to 1.17
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - MarketScan, Linagliptin 2 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.96
    Confidence Interval (2-Sided) 95%
    0.77 to 1.19
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - MarketScan, Linagliptin 3 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.76
    Confidence Interval (2-Sided) 95%
    0.60 to 0.97
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    4. Primary Outcome
    Title Number of Participants With Stroke
    Description Number of participants with ischemic or hemorrhagic stroke. Both types of stroke were included in the definition for stroke, but were not assessed separately
    Time Frame Up to 5 years and 7 months

    Outcome Measure Data

    Analysis Population Description
    1:1 propensity score matched cohorts of linagliptin initiators and comparator groups initiators, identified from Clinformatics and MarketScan database between May 2011 and December 2016.
    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database
    Measure Participants 14688 14688 10614 10614 9538 9538 25135 25135 18996 18996 15742 15742
    Number [Participants]
    42
    0.3%
    42
    0.3%
    30
    0.3%
    30
    0.3%
    37
    0.4%
    16
    0.2%
    113
    0.4%
    104
    0.4%
    66
    0.3%
    74
    0.4%
    76
    0.5%
    53
    0.3%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - Clinformatics, Linagliptin 1 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.89
    Confidence Interval (2-Sided) 95%
    0.58 to 1.38
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - Clinformatics, Linagliptin 2 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.99
    Confidence Interval (2-Sided) 95%
    0.60 to 1.64
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - Clinformatics, Linagliptin 3 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.44
    Confidence Interval (2-Sided) 95%
    0.24 to 0.78
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - MarketScan, Linagliptin 1 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.96
    Confidence Interval (2-Sided) 95%
    0.73 to 1.25
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - MarketScan, Linagliptin 2 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.09
    Confidence Interval (2-Sided) 95%
    0.78 to 1.52
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - MarketScan, Linagliptin 3 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.74
    Confidence Interval (2-Sided) 95%
    0.52 to 1.05
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    5. Secondary Outcome
    Title Number of Participants With Heart Failure Hospitalization
    Description Number of participants with heart failure hospitalization
    Time Frame Up to 5 years and 7 months

    Outcome Measure Data

    Analysis Population Description
    1:1 propensity score matched cohorts of linagliptin initiators and comparator groups initiators, identified from Clinformatics and MarketScan database between May 2011 and December 2016.
    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database
    Measure Participants 14688 14688 10614 10614 9538 9538 25135 25135 18996 18996 15742 15742
    Number [Participants]
    53
    0.4%
    90
    0.6%
    27
    0.3%
    51
    0.5%
    43
    0.5%
    47
    0.5%
    117
    0.5%
    111
    0.4%
    58
    0.3%
    65
    0.3%
    66
    0.4%
    49
    0.3%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - Clinformatics, Linagliptin 1 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.55
    Confidence Interval (2-Sided) 95%
    1.10 to 2.18
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - Clinformatics, Linagliptin 2 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.90
    Confidence Interval (2-Sided) 95%
    1.19 to 3.03
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - Clinformatics, Linagliptin 3 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.11
    Confidence Interval (2-Sided) 95%
    0.73 to 1.68
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - MarketScan, Linagliptin 1 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.99
    Confidence Interval (2-Sided) 95%
    0.76 to 1.29
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - MarketScan, Linagliptin 2 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.10
    Confidence Interval (2-Sided) 95%
    0.77 to 1.56
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - MarketScan, Linagliptin 3 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.79
    Confidence Interval (2-Sided) 95%
    0.54 to 1.14
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    6. Secondary Outcome
    Title Number of Participants With Incident End Stage Renal Disease
    Description Number of participants with incident end stage renal disease (ESRD)
    Time Frame Up to 5 years and 7 months

    Outcome Measure Data

    Analysis Population Description
    1:1 propensity score matched cohorts of linagliptin initiators and comparator groups initiators, identified from Clinformatics and MarketScan database between May 2011 and December 2016. For this outcome only, patients with ESRD at any time prior to and including the day of treatment initiation were excluded.
    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database
    Measure Participants 14472 14472 10467 10467 9422 9422 24714 24741 18689 18689 15500 15500
    Number [Participants]
    49
    0.3%
    75
    0.5%
    28
    0.3%
    48
    0.5%
    38
    0.4%
    43
    0.5%
    90
    0.4%
    116
    0.5%
    39
    0.2%
    61
    0.3%
    53
    0.3%
    57
    0.4%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - Clinformatics, Linagliptin 1 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.40
    Confidence Interval (2-Sided) 95%
    0.97 to 2.00
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - Clinformatics, Linagliptin 2 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.71
    Confidence Interval (2-Sided) 95%
    1.07 to 2.72
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - Clinformatics, Linagliptin 3 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.16
    Confidence Interval (2-Sided) 95%
    0.75 to 1.79
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - MarketScan, Linagliptin 1 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.34
    Confidence Interval (2-Sided) 95%
    1.01 to 1.76
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - MarketScan, Linagliptin 2 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.52
    Confidence Interval (2-Sided) 95%
    1.02 to 2.27
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - MarketScan, Linagliptin 3 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.17
    Confidence Interval (2-Sided) 95%
    0.81 to 1.71
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    7. Secondary Outcome
    Title Number of Participants With Acute Renal Failure
    Description Number of participants with acute renal failure
    Time Frame Up to 5 years and 7 months

    Outcome Measure Data

    Analysis Population Description
    1:1 propensity score matched cohorts of linagliptin initiators and comparator groups initiators, identified from Clinformatics and MarketScan database between May 2011 and December 2016.
    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database
    Measure Participants 14688 14688 10614 10614 9538 9538 25135 25135 18996 18996 15742 15742
    Number [Participants]
    222
    1.5%
    300
    2%
    152
    1.4%
    198
    1.9%
    163
    1.7%
    167
    1.8%
    433
    1.7%
    430
    1.7%
    240
    1.3%
    263
    1.4%
    238
    1.5%
    200
    1.3%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - Clinformatics, Linagliptin 1 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.24
    Confidence Interval (2-Sided) 95%
    1.04 to 1.47
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - Clinformatics, Linagliptin 2 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.31
    Confidence Interval (2-Sided) 95%
    1.06 to 1.61
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - Clinformatics, Linagliptin 3 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.04
    Confidence Interval (2-Sided) 95%
    0.84 to 1.29
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - MarketScan, Linagliptin 1 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.04
    Confidence Interval (2-Sided) 95%
    0.91 to 1.19
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - MarketScan, Linagliptin 2 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.07
    Confidence Interval (2-Sided) 95%
    0.90 to 1.27
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - MarketScan, Linagliptin 3 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.91
    Confidence Interval (2-Sided) 95%
    0.75 to 1.09
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    8. Secondary Outcome
    Title Number of Participants With Acute Renal Failure Requiring Dialysis
    Description Number of patients with acute renal failure requiring dialysis
    Time Frame Up to 5 years and 7 months

    Outcome Measure Data

    Analysis Population Description
    1:1 propensity score matched cohorts of linagliptin initiators and comparator groups initiators, identified from Clinformatics and MarketScan database between May 2011 and December 2016.
    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database
    Measure Participants 14688 14688 10614 10614 9538 9538 25135 25135 18996 18996 15742 15742
    Number [Participants]
    7
    0%
    13
    0.1%
    6
    0.1%
    10
    0.1%
    5
    0.1%
    9
    0.1%
    14
    0.1%
    16
    0.1%
    9
    0%
    9
    0%
    7
    0%
    11
    0.1%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - Clinformatics, Linagliptin 1 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.62
    Confidence Interval (2-Sided) 95%
    0.64 to 4.06
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - Clinformatics, Linagliptin 2 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.67
    Confidence Interval (2-Sided) 95%
    0.61 to 4.58
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - Clinformatics, Linagliptin 3 - Clinformatics
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.84
    Confidence Interval (2-Sided) 95%
    0.62 to 5.48
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection Other DPP-4I - MarketScan, Linagliptin 1 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.17
    Confidence Interval (2-Sided) 95%
    0.57 to 2.40
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 5
    Statistical Analysis Overview Comparison Group Selection Pioglitazone - MarketScan, Linagliptin 2 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.96
    Confidence Interval (2-Sided) 95%
    0.38 to 2.43
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 6
    Statistical Analysis Overview Comparison Group Selection 2nd Gen SUs - MarketScan, Linagliptin 3 - MarketScan
    Comments
    Type of Statistical Test Other
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 1.65
    Confidence Interval (2-Sided) 95%
    0.64 to 4.27
    Parameter Dispersion Type:
    Value:
    Estimation Comments

    Adverse Events

    Time Frame
    Adverse Event Reporting Description As this is a non-interventional study with secondary use of data retrieved from a US health claims database, safety monitoring and safety reporting on an individual case level is not applicable.
    Arm/Group Title Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Arm/Group Description 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of second generation sulfonylureas (2nd gen SUs) and initiators of linagliptin, within Clinformatics database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of other Dipeptidyl peptidase-4 (DPP-4) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of pioglitazone and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database 1:1 propensity score matched cohort of initiators of second generation of sulfonylureas (2nd gen SUs) and initiators of linagliptin, within MarketScan database
    All Cause Mortality
    Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN)
    Serious Adverse Events
    Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN)
    Other (Not Including Serious) Adverse Events
    Other DPP-4I - Clinformatics Linagliptin 1 - Clinformatics Pioglitazone - Clinformatics Linagliptin 2 - Clinformatics 2nd Gen SUs - Clinformatics Linagliptin 3 - Clinformatics Other DPP-4I - MarketScan Linagliptin 1 - MarketScan Pioglitazone - MarketScan Linagliptin 2 - MarketScan 2nd Gen SUs - MarketScan Linagliptin 3 - MarketScan
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN) 0/0 (NaN)

    Limitations/Caveats

    Pioglitazone is contraindicated among patients with heart failure and edema. This suggests pioglitazone may not be a proper comparator in the assessment of the association between linagliptin and heart failure hospitalization or renal outcomes.

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Boehringer Ingelheim, Call Centre
    Organization Boehringer Ingelheim
    Phone 1-800-243-0127
    Email clintriage.rdg@boehringer-ingelheim.com
    Responsible Party:
    Boehringer Ingelheim
    ClinicalTrials.gov Identifier:
    NCT02197078
    Other Study ID Numbers:
    • 1218.163
    First Posted:
    Jul 22, 2014
    Last Update Posted:
    Apr 2, 2020
    Last Verified:
    Mar 1, 2020