TY - JOUR
T1 - COX2 inhibitor use and type 2 diabetes treatment intensification
T2 - A registry-based cohort study
AU - Tan, George S.Q.
AU - Morton, Jedidiah I.
AU - Wood, Stephen
AU - Trevaskis, Natalie L.
AU - Magliano, Dianna J.
AU - Windsor, John
AU - Shaw, Jonathan E.
AU - Ilomäki, Jenni
N1 - Funding Information:
This data was sourced from the National Diabetes Services Scheme (NDSS). The NDSS is an initiative of the Australian Government administered by Diabetes Australia.
Publisher Copyright:
© 2023 The Author(s)
PY - 2024/1
Y1 - 2024/1
N2 - Aim: This study examined the association between cyclooxygenase-2 inhibitor (COX2i) use and diabetes progression in people with type 2 diabetes. Methods: We conducted a nation-wide cohort study using an Australian diabetes registry linked to medication dispensing data. We assessed time to diabetes treatment intensification among new users of COX2i compared to mild opioids. Inverse probability of treatment-weighted Cox regression models were used to adjust for age, sex, time since diabetes diagnosis, comorbidities, and socio-economic disadvantage. We conducted several sensitivity analyses, including per-protocol analyses and comparing use of any NSAID to mild opioids. Results: There were 8,071 new users of COX2i and 7,623 of mild opioids with 4,168 diabetes treatment intensifications over a median follow-up of 1.6 years. Use of COX2i was associated with decreased risk of treatment intensification when compared to mild opioids (HR 0.91, 95 %CI 0.85–0.96). The results were not significant in the per-protocol analyses. Use of any NSAID was associated with a lower risk of treatment intensification compared to mild opioids (HR 0.90, 95 %CI 0.85–0.96). Conclusions: Treatment with COX2i may be associated with a modest decreased risk of diabetes treatment intensification compared to mild opioids. Future clinical studies are required to confirm whether COX2 inhibition has clinically significant benefits for glycaemic control.
AB - Aim: This study examined the association between cyclooxygenase-2 inhibitor (COX2i) use and diabetes progression in people with type 2 diabetes. Methods: We conducted a nation-wide cohort study using an Australian diabetes registry linked to medication dispensing data. We assessed time to diabetes treatment intensification among new users of COX2i compared to mild opioids. Inverse probability of treatment-weighted Cox regression models were used to adjust for age, sex, time since diabetes diagnosis, comorbidities, and socio-economic disadvantage. We conducted several sensitivity analyses, including per-protocol analyses and comparing use of any NSAID to mild opioids. Results: There were 8,071 new users of COX2i and 7,623 of mild opioids with 4,168 diabetes treatment intensifications over a median follow-up of 1.6 years. Use of COX2i was associated with decreased risk of treatment intensification when compared to mild opioids (HR 0.91, 95 %CI 0.85–0.96). The results were not significant in the per-protocol analyses. Use of any NSAID was associated with a lower risk of treatment intensification compared to mild opioids (HR 0.90, 95 %CI 0.85–0.96). Conclusions: Treatment with COX2i may be associated with a modest decreased risk of diabetes treatment intensification compared to mild opioids. Future clinical studies are required to confirm whether COX2 inhibition has clinically significant benefits for glycaemic control.
KW - COX2 inhibitor
KW - Diabetes registry
KW - NSAID
KW - Retrospective cohort study
KW - Treatment intensification
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85182438568&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2023.111082
DO - 10.1016/j.diabres.2023.111082
M3 - Article
C2 - 38160735
AN - SCOPUS:85182438568
SN - 0168-8227
VL - 207
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 111082
ER -
