Combination therapies with thiazolidinediones are associated with a lower risk of acute exacerbations in new-onset COPD patients with advanced diabetic mellitus: a cohort-based case–control study

Table 3 The association between triple oral OADs use and risk of AECOPD in T2DM patients with COPD (n = 3859)

Level of COPD complexity	Combination of OADs	Non-AECOPD controls		AECOPD cases		Odds ratio
Level of COPD complexity	Combination of OADs	n	(%)	n	(%)	Crude	(95% CI)	P	Adjusted*	(95% CI)	P
Overall
	MET + SU + TZD	1074	(35.4)	243	(29.5)	0.81	(0.68–0.95)	0.01	0.81	(0.68–0.96)	0.01
	MET + SU + DPP-4i	933	(30.7)	276	(33.5)	1.00	(0.85–1.17)	0.98	1.02	(0.87–1.21)	0.78
	MET + SU + AGI	1028	(33.9)	305	(37.0)	1.00	(Ref.)		1.00	(Ref.)
Moderate/high
	MET + SU + TZD	479	(32.6)	104	(25.3)	0.76	(0.60–0.97)	0.03	0.75	(0.58–0.96)	0.02
	MET + SU + DPP-4i	440	(29.9)	138	(33.6)	1.02	(0.81–1.28)	0.87	1.06	(0.84–1.34)	0.63
	MET + SU + AGI	552	(37.5)	169	(41.1)	1.00	(Ref.)		1.00	(Ref.)
Low
	MET + SU + TZD	595	(38.0)	139	(33.7)	0.85	(0.67–1.08)	0.18	0.88	(0.79–1.28)	0.28
	MET + SU + DPP-4i	493	(31.5)	138	(33.4)	0.98	(0.78–1.25)	0.89	1.00	(0.69–1.11)	0.97
	MET + SU + AGI	476	(30.4)	136	(32.9)	1.00	(Ref.)		1.00	(Ref.)

^*Adjusted for age, sex, DM status, previous and coexisting disease conditions, modified CCI, complexity of COPD and COPD medications listed in Table 1
AECOPD acute exacerbations of chronic obstructive pulmonary disease, AGI α-glucosidase inhibitors, CCI Charlson comorbidity index, CI confidence interval, DPP‐4i dipeptidyl peptidase‐4 inhibitor, DM diabetes, MET metformin, OADs oral antihyperglycemic drugs, OR odd ratio, Ref. reference group, SU sulfonylurea, TZD thiazolidinediones

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