Abstract Details

Title Sodium-glucose Co-transporter 2 Inhibitors Lower the Risk for Dementia in Patients with Type 2 Diabetes Mellitus

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S28 - Vascular and Other Non-Alzheimer’s Dementias (1:36 PM-1:48 PM)

Poster/Presentation
Number 004

Background

Oral antidiabetic drugs (OADs) including metformin, dipeptidyl peptidase-4 inhibitor (DPP4i), and sodium-glucose cotransporter 2 inhibitors (SGLT2i) for type 2 diabetes mellitus (T2DM) have been explored in clinical trials as potential therapeutic candidates that may be repurposed for dementia. The aim of the present study was to investigate whether the use of SGLT2i may prevent dementia in patients with T2DM.

Objective To assess the potential protective effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on the onset of dementia, including vascular dementia (VaD), Alzheimer's disease (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB), in patients with type 2 diabetes mellitus (T2DM) compared to those treated with dipeptidyl peptidase-4 inhibitors (DPP4i).

Design/Methods

This was a population-based cohort study that enrolled adult patients with T2DM from 92 hospitals across the United States. SGLT2i users were 1:1 propensity score matched to DPP4i users on demographics, comorbidities, co-medications, and healthcare utilization. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for new-onset dementia, vascular dementia (VaD), Alzheimer's disease (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB).

Results

Before propensity score matching (PSM), a total of 1,977,424 patients with T2DM were included in the study, including 800,337 patients on SGLT2i and 1,177,087 patients on DPP4i. After PSM, 722,347 patients were included in the two arms, respectively. Patients with T2DM on SGLT2i presented with a significantly lower risk of new-onset dementia (HR: 0.56; 95% CI, 0.54-0.57), VaD (HR: 0.58; 95% CI, 0.54-0.61), AD (HR: 0.52; 95% CI, 0.49-0.54), FTD (HR: 0.68; 95% CI, 0.55-0.84), and DLB (HR 0.50; 95% CI, 0.42-0.60) compared to patients with T2DM on DPP4i.

Conclusions

The use of SGLT2i for T2DM was associated with a significant reduction in the risk of dementia, VaD, AD, FTD, and DLB, compared with DPP4i.

Authors/Disclosures
Shih-Syuan Wang, MD (SUNY Downstate Medical Center) PRESENTER	Dr. Wang has nothing to disclose.
Steven E. Arnold, MD (Massachusetts General Hospital)	Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EIP Pharma. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sage Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cortexyme. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Boyle Shaughnessy Law. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Wolf Greenfield. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Advisory Board Member with Bob's Last Marathon.
Alvaro Pascual-Leone, MD, PhD, FAAN (Marcus Institute for Aging Research & Wolk Center for Memory Health)	Dr. Pascual-Leone has received personal compensation for serving as an employee of Linus Health. Dr. Pascual-Leone has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Magstim. Dr. Pascual-Leone has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neuroelectrics. Dr. Pascual-Leone has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TetraNeuron. Dr. Pascual-Leone has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MedRhythms. Dr. Pascual-Leone has received personal compensation in the range of $100,000-$499,999 for serving as an officer or member of the Board of Directors for Linus Health. Dr. Pascual-Leone has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Annals of Neurology. Dr. Pascual-Leone has stock in TI Solutions. The institution of Dr. Pascual-Leone has received research support from NIH. The institution of Dr. Pascual-Leone has received research support from NSF. The institution of Dr. Pascual-Leone has received research support from Brightfocus Foundation . Dr. Pascual-Leone has received intellectual property interests from a discovery or technology relating to health care. Dr. Pascual-Leone has received publishing royalties from a publication relating to health care.
Pin-Chia Huang	No disclosure on file
Kevin Sheng-Kai Ma	Dr. MA has nothing to disclose.