Fluoroquinolones and the risk of severe hypoglycaemia among sulphonylurea users: Population‐based cohort study-Reference-Cited by-同舟云学术

Fluoroquinolones and the risk of severe hypoglycaemia among sulphonylurea users: Population‐based cohort study

Published:2024-05-02 Issue:8 Volume:26 Page:3088-3098
ISSN:1462-8902
Container-title:Diabetes, Obesity and Metabolism
language:en
Short-container-title:Diabetes Obesity Metabolism

Author:

Dimakos Jenny¹,Cui Ying²,Platt Robert W.²³⁴,Renoux Christel²³⁵,Filion Kristian B.¹²³^ORCID,Douros Antonios¹²³⁶^ORCID

Affiliation:

1. Department of Medicine McGill University Montreal Canada

2. Centre for Clinical Epidemiology Lady Davis Institute Montreal Canada

3. Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Canada

4. Department of Pediatrics McGill University Montreal Canada

5. Department of Neurology and Neurosurgery McGill University Montreal Canada

6. Institute of Clinical Pharmacology and Toxicology Charité‐Universitätsmedizin Berlin Berlin Germany

Abstract

AbstractAimFluoroquinolone‐related hypoglycaemia is rare but may become clinically relevant in individuals at high baseline hypoglycaemic risk, such as patients with diabetes using sulphonylureas. Our population‐based cohort study assessed whether fluoroquinolones are associated with an increased risk of severe hypoglycaemia compared with amoxicillin among patients treated with sulphonylureas.Materials and MethodsUsing the UK's Clinical Practice Research Datalink Aurum linked to hospitalization and vital statistics data, we assembled a base cohort of patients who initiated second‐generation sulphonylureas (1998‐2020). The study cohort included patients initiating either fluoroquinolones or amoxicillin while on sulphonylureas. Using an intent‐to‐treat exposure definition, we assessed the 30‐day risk of severe hypoglycaemia (hospitalization with or death because of hypoglycaemia) associated with fluoroquinolones compared with amoxicillin. Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) of severe hypoglycaemia after 1:5 matching on previous sulphonylurea use and propensity scores. Secondary analyses were stratified by demographics and glycated haemoglobin.ResultsOverall, 143 417 patients initiated fluoroquinolones (n = 13 123) or amoxicillin (n = 130 294) while on sulphonylureas. Compared with amoxicillin, fluoroquinolones were not associated with the risk of severe hypoglycaemia (HR, 1.17; 95% CI, 0.91‐1.50). Fluoroquinolones were associated with an increased risk in patients <65 years (HR, 2.90; 95% CI, 1.41‐5.97) but not in those ≥65 years (HR, 1.03; 95% CI, 0.79‐1.35) in stratified analyses. There was no evidence of effect modification by sex or glycated haemoglobin.ConclusionsIn patients using second‐generation sulphonylureas, fluoroquinolones were not associated with an increased risk of severe hypoglycaemia compared with amoxicillin. An increased risk among younger adults is possible.

Funder

Canadian Institutes of Health Research

Publisher

Wiley

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