{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:10:32Z","timestamp":1788441032614,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004948","name":"Astellas Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004948","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>Severe diabetic macular edema (DME) is often resistant to anti\u2010vascular endothelial growth factor therapy. Steroids are particularly effective at reducing edema by suppressing inflammation; they are also used as an alternative to expensive anti\u2010vascular endothelial growth factor therapy in some patients. Therefore, the use of steroids in DME reflects an unmet need for anti\u2010vascular endothelial growth factor therapy. Notably, triamcinolone acetonide (TA) injections are widely used in Japan. Here, we evaluated the frequency of TA as an indicator of the efficacy of sodium\u2013glucose cotransporter\u20092 inhibitors (SGLT2is) in DME treatment using a health insurance claims database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>In this cohort study, we retrospectively analyzed the health insurance claims data of 11\u2009million Japanese individuals from 2005 to 2019. The frequency and duration of TA injection after the initiation of SGLT2is or other antidiabetic drugs were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 2,412 matched patients with DME, the incidence rate of TA injection was 63.8 times per 1,000 person\u2010years in SGLT2i users and 94.9 times per 1,000 person\u2010years in non\u2010users. SGLT2is reduced the risk for the first (<jats:italic>P<\/jats:italic>\u2009=\u20090.0024, hazard ratio 0.66, 95% confidence interval 0.50\u20130.87), second (<jats:italic>P<\/jats:italic>\u2009=\u20090.0019, hazard ratio 0.53, 95% confidence interval 0.35\u20130.80) and third TA (<jats:italic>P<\/jats:italic>\u2009=\u20090.0053, hazard ratio 0.44, 95% confidence interval 0.25\u20130.80) injections. A subanalysis of each baseline characteristic of the patients showed that SGLT2is were effective regardless of the background factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of SGLT2is reduced the frequency of TA injection in patients with DME. Therefore, SGLT2i therapy might be a novel, noninvasive and low\u2010cost adjunctive therapy for DME.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.14253","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T11:20:03Z","timestamp":1718364003000},"page":"1231-1238","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Sodium\u2013glucose cotransporter\u20092 inhibitor therapy reduces the administration frequency of steroid injection in patients with diabetic macular edema: A cohort study using the Japanese health insurance claims database"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2535-5396","authenticated-orcid":false,"given":"Ryoichi","family":"Ishibashi","sequence":"first","affiliation":[{"name":"Division of Diabetes, Endocrinology and Metabolism, Department of Medicine Kimitsu Chuo Hospital  Kisarazu Japan"},{"name":"Department of Endocrinology, Hematology, and Gerontology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7374-9993","authenticated-orcid":false,"given":"Masaya","family":"Koshizaka","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hematology, and Gerontology, Graduate School of Medicine Chiba University  Chiba Japan"},{"name":"Center for Preventive Medical Sciences Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Takatsuna","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Chiba Rosai Hospital  Ichihara Japan"},{"name":"Department of Ophthalmology and Vision Science, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Tatsumi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiro","family":"Maezawa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hematology, and Gerontology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Shiko","sequence":"additional","affiliation":[{"name":"Clinical Research Center Chiba University Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Inaba","sequence":"additional","affiliation":[{"name":"Clinical Research Center Chiba University Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohei","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Clinical Research Center Chiba University Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kashiwagi","sequence":"additional","affiliation":[{"name":"Department of Artificial Intelligence Medicine, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiryo","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Artificial Intelligence Medicine, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Clinical Research Center Chiba University Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koutaro","family":"Yokote","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hematology, and Gerontology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414264"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2017.6565"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-022-02326-8"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.01.031"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-021-05369-9"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-34673-z"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/1673-5374.355743"},{"key":"e_1_2_9_9_1","first-page":"e204","article-title":"Anti\u2010VEGF and steroid combination therapy relative to anti\u2010VEGF mono therapy for the treatment of refractory DME: A systematic review of efficacy and meta\u2010analysis of safety","volume":"102","author":"Hatamnejad A","year":"2023","journal-title":"Acta 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