Preadmission GLP-1 Receptor Agonist Plus SGLT2 Inhibitor Use and Early Outcomes After Pneumonia Hospitalization in Adults With Type 2 Diabetes

NCT07708610 | Not Yet Recruiting

• 1 other identifier: CS2-26152
• Study Type: observational
• Target: 71,775
• Locations: 1 country
• Sites: 1

Brief Summary

This retrospective observational target-trial emulation uses electronic health record data from the TriNetX US Collaborative Network to compare preadmission glucose-lowering treatment strategies in adults with type 2 diabetes hospitalized with pneumonia. Time zero is the date of the index pneumonia admission. The study compares patients with evidence of prescriptions for both a GLP-1 receptor agonist and an SGLT2 inhibitor in the year before admission with patients prescribed a GLP-1 receptor agonist alone, an SGLT2 inhibitor alone, or usual care. Usual care includes metformin, sulfonylureas, or DPP-4 inhibitors without either study class. The primary outcome is a composite of all-cause death, invasive mechanical ventilation, or renal replacement therapy within 30 days of admission, with the individual components and 12-month mortality, major adverse cardiovascular events, and major adverse kidney events also evaluated. Propensity-score methods are used to reduce bias from nonrandom treatment selection.

Conditions

Pneumonia; Type 2 Diabetes Mellitus (T2DM)

Outcome Measures

Primary Outcomes (1)

• Composite outcome (all-cause mortality, invasive mechanical ventilation, or renal replacement therapy)

  Within 30 days after the index pneumonia admission

Secondary Outcomes (7)

• All-cause mortality

  Within 30 days after the index pneumonia admission

• Invasive mechanical ventilation

  Within 30 days after the index pneumonia admission

• Renal replacement therapy

  Within 30 days after the index pneumonia admission

• Composite outcome (all-cause mortality, major adverse cardiovascular events, or major adverse kidney events)

  Through 12 months after the index pneumonia admission

• All-cause mortality

  Through 12 months after the index pneumonia admission

Study Arms (4)

GLP-1 RA plus SGLT2i

Adults with type 2 diabetes hospitalized with pneumonia who had prescriptions for both a GLP-1 receptor agonist and an SGLT2 inhibitor in the year before admission.

GLP-1 RA alone

Adults with type 2 diabetes hospitalized with pneumonia who had a prescription for a GLP-1 receptor agonist, and no prescription for an SGLT2 inhibitor, in the year before admission.

SGLT2i alone

Adults with type 2 diabetes hospitalized with pneumonia who had a prescription for an SGLT2 inhibitor, and no prescription for a GLP-1 receptor agonist, in the year before admission.

Usual care

Adults with type 2 diabetes hospitalized with pneumonia who had a prescription for metformin, a sulfonylurea, or a DPP-4 inhibitor, and no prescription for a GLP-1 receptor agonist or an SGLT2 inhibitor, in the year before admission.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adults will be selected from the TriNetX US Collaborative Network, a distributed database of de-identified electronic health records contributed by participating healthcare organizations across multiple clinical systems and practice settings. The study population consists of adults with type 2 diabetes who were hospitalized with pneumonia and received routine clinical care in this network, identified through diagnosis records, laboratory data, encounter records, and medication prescribing data. Comparator-specific cohorts were defined within this source population according to glucose-lowering prescriptions recorded in the year before the index admission, to evaluate preadmission GLP-1 receptor agonist- and SGLT2 inhibitor-based treatment strategies.

You may qualify if:

• Adults aged 18 years or older.
• Type 2 diabetes mellitus
• Hospitalization with pneumonia during the study period, serving as the index admission
• Prescription of a GLP-1 receptor agonist, an SGLT2 inhibitor, or usual-care glucose-lowering therapy in the year before the index admission
• No GLP-1 receptor agonist or SGLT2 inhibitor prescription in the 6 months before the first qualifying prescription

You may not qualify if:

• Type 1 diabetes mellitus, or other specified diabetes types that are not type 2 diabetes
• Human immunodeficiency virus infection
• Bariatric surgery
• Solid-organ transplantation
• Pneumonia hospitalization, invasive mechanical ventilation, or renal replacement therapy in the year before the index admission
• End-stage kidney disease, dialysis dependence, ventilator dependence, or tracheostomy status
• Metastatic malignancy, lung cancer, or palliative care
• Viral pneumonia, influenza with pneumonia, or COVID-19 around the index admission
• Acute cardiovascular event in the 6 months before the index admission

Sponsors & Collaborators

• Chung Shan Medical University: lead
• National Science and Technology Council, Taiwan: collaborator

Study Sites (1)

Chung Shan Medical University Hospital

Taichung, Taichung, 402, Taiwan

Location

Related Publications (22)

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MeSH Terms

Conditions

Pneumonia; Diabetes Mellitus, Type 2

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Infections; Lung Diseases; Respiratory Tract Diseases; Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Central Study Contacts

Pen-Hua Su, PhD

CONTACT

886-4-24739595; jen@csh.org.tw

Yu-Nan Huang, PhD

CONTACT

886-4-24739595; yunanhuang83@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor/Research Fellow

Study Record Dates

• First Submitted: July 13, 2026
• First Posted: July 16, 2026
• Study Start: July 31, 2026
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): August 31, 2026
• Last Updated: July 16, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)