TY - JOUR
T1 - Sitagliptin treatment at the time of hospitalization was associated with reduced mortality in patients with type 2 diabetes and covid-19
T2 - A multicenter case-control retrospective observational study
AU - Solerte, Sebastiano Bruno
AU - D’Addio, Francesca
AU - Trevisan, Roberto
AU - Lovati, Elisabetta
AU - Rossi, Antonio
AU - Pastore, Ida
AU - Acqua, Marco Dell
AU - Ippolito, Elio
AU - Scaranna, Cristiana
AU - Bellante, Rosalia
AU - Galliani, Silvia
AU - Dodesini, Alessandro Roberto
AU - Lepore, Giuseppe
AU - Geni, Francesca
AU - Fiorina, Roberta Maria
AU - Catena, Emanuele
AU - Corsico, Angelo
AU - Colombo, Riccardo
AU - Mirani, Marco
AU - Riva De, Carlo
AU - Oleandri, Salvatore Endrio
AU - Abdi, Reza
AU - Bonventre, Joseph V.
AU - Rusconi, Stefano
AU - Folli, Franco
AU - Sabatino, Antonio Di
AU - Zuccotti, Gianvincenzo
AU - Galli, Massimo
AU - Fiorina, Paolo
N1 - Funding Information:
Acknowledgments. The authors thank the “Fon-dazione Romeo ed Enrica Invernizzi” for extraor-dinarysupport.TheauthorsalsothankMediolanum Farmaceutici for providing sitagliptin and Dr. Giorgio Bedogni, statistician (Clinical Epidemiology Unit, Liver Research Center, Trieste, Italy), for support in the data analysis. Funding. F.D’A. is supported by a Società Italiana di Diabetologia Lombardia Grant and by the Eu-ropeanFoundationfortheStudyofDiabetes/JDRF/ Lilly European Programme on Type 1 Diabetes Research 2019. P.F. is supported by Italian Ministry ofHealthgrantRF-2016-02362512andbytheLinea 2 2019 funding from Università di Milano. R.A. is the recipient of Stepping Strong Innovator Award 116260. Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. S.B.S., F.D’A., and R.T. analyzed data and wrote the manuscript. E.L., A.R., I.P., M.D’A., E.I., R.M.F., and E.C. collected data. C.S., R.B., S.G., A.R.D., G.L., F.G., R.C., M.M., C.D.R., and S.E.O. enrolled patients in the study. A.C., R.A., J.V.B., S.R., F.F., A.D.S., G.Z., and M.G. coordinated and designed research and edited the manuscript. S.B.S. and P.F. conceived the idea, designed the study, and wrote and edited the manuscsript. P.F. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Publisher Copyright:
© 2020 by the American Diabetes Association.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - OBJECTIVE Poor outcomes have been reported in patients with type 2 diabetes and coronavirus disease 2019 (COVID-19); thus, it is mandatory to explore novel therapeutic approaches for this population. RESEARCH DESIGN AND METHODS In a multicenter, case-control, retrospective, observational study, sitagliptin, an oral and highly selective dipeptidyl peptidase 4 inhibitor, was added to standard of care (e.g., insulin administration) at the time of hospitalization in patients with type 2 diabetes who were hospitalized with COVID-19. Every center also recruited at a 1:1 ratio untreated control subjects matched for age and sex. All patients had pneumonia and exhibited oxygen saturation <95% when breathing ambient air or when receiving oxygen support. The primary end points were discharge from the hospital/death and improvement of clinical outcomes, defined as an increase in at least two points on a seven-category modified ordinal scale. Data were collected retrospectively from patients receiving sitagliptin from 1 March through 30 April 2020. RESULTS Of the 338 consecutive patients with type 2 diabetes and COVID-19 admitted in Northern Italy hospitals included in this study, 169 were on sitagliptin, while 169 were on standard of care. Treatment with sitagliptin at the time of hospitalization was associated with reduced mortality (18% vs. 37% of deceased patients; hazard ratio 0.44 [95% CI 0.29–0.66]; P = 0.0001), with an improvement in clinical outcomes (60% vs. 38% of improved patients; P = 0.0001) and with a greater number of hospital discharges (120 vs. 89 of discharged patients; P = 0.0008) compared with patients receiving standard of care, respectively. CONCLUSIONS In this multicenter, case-control, retrospective, observational study of patients with type 2 diabetes admitted to the hospital for COVID-19, sitagliptin treatment at the time of hospitalization was associated with reduced mortality and improved clinical outcomes as compared with standard-of-care treatment. The effects of sitagliptin in patients with type 2 diabetes and COVID-19 should be confirmed in an ongoing randomized, placebo-controlled trial.
AB - OBJECTIVE Poor outcomes have been reported in patients with type 2 diabetes and coronavirus disease 2019 (COVID-19); thus, it is mandatory to explore novel therapeutic approaches for this population. RESEARCH DESIGN AND METHODS In a multicenter, case-control, retrospective, observational study, sitagliptin, an oral and highly selective dipeptidyl peptidase 4 inhibitor, was added to standard of care (e.g., insulin administration) at the time of hospitalization in patients with type 2 diabetes who were hospitalized with COVID-19. Every center also recruited at a 1:1 ratio untreated control subjects matched for age and sex. All patients had pneumonia and exhibited oxygen saturation <95% when breathing ambient air or when receiving oxygen support. The primary end points were discharge from the hospital/death and improvement of clinical outcomes, defined as an increase in at least two points on a seven-category modified ordinal scale. Data were collected retrospectively from patients receiving sitagliptin from 1 March through 30 April 2020. RESULTS Of the 338 consecutive patients with type 2 diabetes and COVID-19 admitted in Northern Italy hospitals included in this study, 169 were on sitagliptin, while 169 were on standard of care. Treatment with sitagliptin at the time of hospitalization was associated with reduced mortality (18% vs. 37% of deceased patients; hazard ratio 0.44 [95% CI 0.29–0.66]; P = 0.0001), with an improvement in clinical outcomes (60% vs. 38% of improved patients; P = 0.0001) and with a greater number of hospital discharges (120 vs. 89 of discharged patients; P = 0.0008) compared with patients receiving standard of care, respectively. CONCLUSIONS In this multicenter, case-control, retrospective, observational study of patients with type 2 diabetes admitted to the hospital for COVID-19, sitagliptin treatment at the time of hospitalization was associated with reduced mortality and improved clinical outcomes as compared with standard-of-care treatment. The effects of sitagliptin in patients with type 2 diabetes and COVID-19 should be confirmed in an ongoing randomized, placebo-controlled trial.
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U2 - 10.2337/dc20-1521
DO - 10.2337/dc20-1521
M3 - Article
C2 - 32994187
AN - SCOPUS:85095948711
VL - 43
SP - 2999
EP - 3006
JO - Diabetes Care
JF - Diabetes Care
SN - 1935-5548
IS - 12
ER -