- In patients with type 2 diabetes (T2D), glimepiride was associated with a lower incidence of all-cause mortality compared with other second-generation sulfonylureas while there was a non-significant trend towards a higher incidence of severe hypoglyceamia.
- No significant difference was observed in the incidence of myocardial infarction (MI) and ischaemic stroke between glimepiride and other second-generation sulfonylureas.
Why this matters
- Findings may help in interpreting the upcoming results of the GRADE and CAROLINA trials that used glimepiride as an active comparator with respect to other commonly used sulfonylureas.
- This study included 66,032 patients with T2D who initiated a sulfonylurea between 1998 and June 2016 using the Clinical Practice Research Datalink (CPRD).
- Glimepiride initiators were matched (1:4) with other second-generation sulfonylureas initiators.
- Main outcomes: myocardial infarction, ischaemic stroke, severe hypoglycaemia, cardiovascular death, and all-cause mortality.
- Funding: The Canadian Institutes of Health Research and others.
- Glimepiride vs other second-generation sulfonylureas was associated with a similar incidence of MI (HR, 0.99; 95% CI, 0.75-1.30) and ischaemic stroke (HR, 0.96; 95% CI, 0.72-1.27) whereas there was a non-significant trend towards a higher incidence of severe hypoglycemia (HR, 1.24; 95% CI, 0.92-1.68).
- Glimepiride was associated with a reduction in the incidence of all-cause mortality (HR, 0.77; 95% CI, 0.67-0.89) and a non-significant but similar trend for cardiovascular death (HR, 0.83; 95% CI, 0.65-1.05).
- Risk of residual confounding.
- Short follow-up period.