DPP4is, GLP-1 Receptor Agonists Linked to Reduced Incidence of Parkinson’s Disease in T2D

Sarfaroj Khan 

Disclosures

October 13, 2020

Takeaway

  • The incidence of Parkinson’s disease (PD) in patients with type 2 diabetes (T2D) varies substantially depending on the treatment received for diabetes.

  • The use of dipeptidyl peptidase-4 inhibitors (DPP4is) and/or glucagon-like peptide-1 (GLP-1) receptor agonists is associated with a lower rate of PD compared with the use of other oral antidiabetic drugs.

Why this matters

  • Findings provide unique evidence to support further investigation of DPP4is and GLP-1 receptor agonists use in PD.

Study design

  • This population-based, longitudinal, cohort study included 100,288 T2D patients with ≥2 antidiabetic prescriptions (mean age, 62.8 years) using data from The Health Improvement Network (THIN; 2006-2019).

  • Primary outcome: first recording of PD diagnosis after the index date.

  • Funding: The Cure Parkinson’s Trust.

Key results

  • Of 100,288 patients, 329 (0.3%) were diagnosed with PD during the median follow-up of 3.33 years.

  • The incidence of PD was:

    • 8 per 10,000 person-years in glitazones users (GTZ; n=21,175);

    • 5 per 10,000 person-years in DPP4is users (n=36,897); and

    • 4 per 10,000 person-years in GLP-1 receptor agonists users (n=10,684); of these, 6861 were prescribed GTZ and/or DPP4is prior to GLP-1 receptor agonists.

  • Compared with the incidence of PD in the comparison group (10 per 10 000 person-years), the adjusted analysis showed no evidence of an association between the use of GTZ and PD (incidence rate ratio [IRR], 1.17; 95% CI, 0.76-1.63; P=.467).

  • A strong inverse association was observed between the use of DPP4is (IRR, 0.64; 95% CI, 0.43-0.88; P<.01) and GLP-1 receptor agonists (IRR, 0.38; 95% CI, 0.17-0.60) and the onset of PD.

  • Results for insulin users were in the same direction, but the overall size of this group was small.

Limitations

  • Risk of bias.

 

Brauer R, Wei L, Ma T, Athauda D, Girges C, Vijiaratnam N, Auld G, Whittlesea C, Wong I, Foltynie T. Diabetes medications and risk of Parkinson's disease: a cohort study of patients with diabetes. Brain. 2020 Oct 4 [Epub ahead of print]. doi: 10.1093/brain/awaa262. PMID: 33011770 View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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