Antihyperglycemic Agents Have No Effect on All-Cause Mortality

No single agent or combination of oral antihyperglycemic agents has any significant effect on all-cause mortality, according to a new study. Those findings come from a study of diabetics in the Veterans Health Administration (VHA), led by Dr. Kristijan H. Kahler of the VA New Jersey Health Care System in East Orange, and Novartis Pharmaceuticals in East Hanover, New Jersey, and are published in the July issue of Diabetes Care.

The team has been studying 39,721 diabetics divided into groups according to oral antihyperglycemic therapy: sulfonylurea monotherapy, metformin monotherapy, metformin plus sulfonylurea, thiazolidinedione (TZD) monotherapy or in combination with other oral agents (TZD users), and a group on no drug therapy.

The primary outcome measure was all-cause mortality.

The VHA study has been ongoing since 1996. During its first decade, the adjusted odds ratios for all-cause mortality were 0.87 for metformin monotherapy users, 0.92 for metformin plus sulfonylurea users, and 1.04 for TZD users, relative to sulfonylurea monotherapy users.

"We did not find any significant drug effect on all-cause mortality for any oral treatment cohorts relative to sulfonylurea oral monotherapy," Dr. Kahler and associates report.

"Future work should assess whether long-term exposure to oral antihyperglycemic medications reduces all-cause or cause-specific mortality," the investigators note.
Diabetes Care 2077;30:1689-1693.

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FACT:
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