The clinical effectiveness of sodium-glucose co-transporter-2 inhibitors on prognosis of patients with chronic obstructive pulmonary disease and diabetes

Diabetes is common in patients with chronic obstructive pulmonary disease. Sodium-glucose co-transporter-2 inhibitors are effective in treating type 2 diabetes and provide benefits for conditions like cardiovascular and kidney diseases. We use data from multiple institutions and countries to evaluate their role in patients with chronic obstructive pulmonary disease and diabetes. This study includes chronic obstructive pulmonary disease patients with diabetes who are newly prescribed sodium-glucose co-transporter-2 inhibitors or dipeptidyl peptidase-4 inhibitors between January 1, 2013, and August 25, 2024. The primary outcome is all-cause mortality. The results show that the sodium-glucose co-transporter-2 inhibitors group has a lower risk of all-cause mortality compared to the dipeptidyl peptidase-4 inhibitors group (hazard ratio, 0.757; 95% confidence interval, 0.716-0.801). It also shows significantly lower risks of all-cause hospitalization (hazard ratio, 0.864; 95% confidence interval, 0.845-0.884), exacerbation (hazard ratio, 0.924; 95% confidence interval, 0.888-0.962), pneumonia, upper respiratory infections, bronchitis, and major cardiovascular events.