Trial Outcomes & Findings for Second-line Therapies for Patients With Type 2 Diabetes and Moderate Cardiovascular Disease Risk (NCT NCT05214573)

Last Updated: 2025-10-10

Results Overview

The probability of 3-point MACEs experienced by subjects treated with DPP4i, GLP-1RA, SGLT2i, or Sulfonylureas (SU) defined as non-fatal myocardial infarction (MI), non-fatal stroke, and mortality. The probability was calculated and reported as the hazard ratio.

Recruitment status

COMPLETED

Target enrollment

386301 participants

Primary outcome timeframe

Retrospective Data between 1/1/2014 - 12/31/2022, up to 8 years, collected over a 2-year period

Results posted on

2025-10-10

Participant Flow

Participants in the arm "Aims 1, 2B, and 3 groups", were considered enrolled in the trial even though this arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data.

Participant milestones

Participant milestones
Measure	Aims 1, 2B, and 3 Groups De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea	Aim 2A Group Adults with Type 2 diabetes treated with one or more of the study medications (GLP-1RA, SGLT2i, DPP-4i, or SU) and not treated with insulin who received medical care at Mayo Clinic Rochester or Mayo Clinic Health System in Minnesota or Wisconsin. This arm was not exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were applicable as this arm collected prospective data.
Overall Study STARTED	386276	25
Overall Study COMPLETED	380352	25
Overall Study NOT COMPLETED	5924	0

Reasons for withdrawal

Reasons for withdrawal
Measure	Aims 1, 2B, and 3 Groups De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea	Aim 2A Group Adults with Type 2 diabetes treated with one or more of the study medications (GLP-1RA, SGLT2i, DPP-4i, or SU) and not treated with insulin who received medical care at Mayo Clinic Rochester or Mayo Clinic Health System in Minnesota or Wisconsin. This arm was not exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were applicable as this arm collected prospective data.
Overall Study Physician Decision	5924	0

Baseline Characteristics

Second-line Therapies for Patients With Type 2 Diabetes and Moderate Cardiovascular Disease Risk

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Aims 1, 2B, and 3 Groups n=386276 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea	Aim 2A Group n=25 Participants Adults with Type 2 diabetes treated with one or more of the study medications (GLP-1RA, SGLT2i, DPP-4i, or SU) and not treated with insulin who received medical care at Mayo Clinic Rochester or Mayo Clinic Health System in Minnesota or Wisconsin. This arm was not exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were applicable as this arm collected prospective data.	Total n=386301 Participants Total of all reporting groups
Age, Categorical <=18 years	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Age, Categorical Between 18 and 65 years	131786 Participants n=5 Participants	19 Participants n=7 Participants	131805 Participants n=5 Participants
Age, Categorical >=65 years	254490 Participants n=5 Participants	6 Participants n=7 Participants	254496 Participants n=5 Participants
Sex: Female, Male Female	190394 Participants n=5 Participants	13 Participants n=7 Participants	190407 Participants n=5 Participants
Sex: Female, Male Male	195882 Participants n=5 Participants	12 Participants n=7 Participants	195894 Participants n=5 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	33165 Participants n=5 Participants	5 Participants n=7 Participants	33170 Participants n=5 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	341028 Participants n=5 Participants	19 Participants n=7 Participants	341047 Participants n=5 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	12083 Participants n=5 Participants	1 Participants n=7 Participants	12084 Participants n=5 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Asian	10982 Participants n=5 Participants	0 Participants n=7 Participants	10982 Participants n=5 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Black or African American	39454 Participants n=5 Participants	1 Participants n=7 Participants	39455 Participants n=5 Participants
Race (NIH/OMB) White	285574 Participants n=5 Participants	20 Participants n=7 Participants	285594 Participants n=5 Participants
Race (NIH/OMB) More than one race	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Unknown or Not Reported	50266 Participants n=5 Participants	4 Participants n=7 Participants	50270 Participants n=5 Participants
Region of Enrollment United States	386276 participants n=5 Participants	25 participants n=7 Participants	386301 participants n=5 Participants

PRIMARY outcome

Timeframe: Retrospective Data between 1/1/2014 - 12/31/2022, up to 8 years, collected over a 2-year period

Population: 380352 total participants were analyzed. Those 380352 participants were further broken down into the following categories DPP4i (82438), GLP-1RA (44255), SGLT2i (46473), Sulfonylureas (SU) (207186), respectively.

Outcome measures

Outcome measures
Measure	Aims 1, 2B, and 3 Groups n=380352 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea
3-point Major Adverse Cardiovascular Event (MACE) GLP-1RA versus DPP4i	0.87 Hazard Ratio Interval 0.82 to 0.93
3-point Major Adverse Cardiovascular Event (MACE) SGLT2i versus DPP4i	0.85 Hazard Ratio Interval 0.81 to 0.9
3-point Major Adverse Cardiovascular Event (MACE) SU versus DPP4i	1.19 Hazard Ratio Interval 1.16 to 1.22
3-point Major Adverse Cardiovascular Event (MACE) SGLT2i versus GLP-1RA	0.97 Hazard Ratio Interval 0.9 to 1.05
3-point Major Adverse Cardiovascular Event (MACE) SU versus GLP-1RA	1.36 Hazard Ratio Interval 1.28 to 1.46
3-point Major Adverse Cardiovascular Event (MACE) SU versus SGLT2i	1.40 Hazard Ratio Interval 1.33 to 1.47

PRIMARY outcome

Timeframe: Retrospective Data between 1/1/2014 - 12/31/2022, up to 8 years, collected over a 2-year period

The probability of 3-point MACEs (non-fatal MI, non-fatal stroke, mortality) plus heart failure hospitalization and revascularization procedure events experienced by subjects treated with DPP4i, GLP-1RA, SGLT2i, or Sulfonylureas (SU). The probability was calculated and reported as the hazard ratio.

Outcome measures

Outcome measures
Measure	Aims 1, 2B, and 3 Groups n=380352 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea
Expanded Major Adverse Cardiovascular Events (MACE) and Its Components GLP-1RA versus DPP4i	0.95 Hazard Ratio Interval 0.91 to 1.0
Expanded Major Adverse Cardiovascular Events (MACE) and Its Components SGLT2i versus DPP4i	0.93 Hazard Ratio Interval 0.89 to 0.96
Expanded Major Adverse Cardiovascular Events (MACE) and Its Components SU versus DPP4i	1.14 Hazard Ratio Interval 1.12 to 1.17
Expanded Major Adverse Cardiovascular Events (MACE) and Its Components SGLT2i versus GLP-1RA	0.97 Hazard Ratio Interval 0.92 to 1.02
Expanded Major Adverse Cardiovascular Events (MACE) and Its Components SU versus GLP-1RA	1.20 Hazard Ratio Interval 1.15 to 1.26
Expanded Major Adverse Cardiovascular Events (MACE) and Its Components SU versus SGLT2i	1.24 Hazard Ratio Interval 1.2 to 1.28

PRIMARY outcome

Timeframe: 1 hour

Patients ranked treatment outcomes using a participatory ranking questionnaire. The questionnaire included a list of 16 health outcomes and eight medication attributes, with opportunities for participants to add outcomes and attributes into the ranking lists. During the exercise, participants were asked to assign each outcome and attribute to one of three mutually exclusive categories: "very important," "somewhat important," or "not very important," based on the degree to which each outcome or attribute would influence their choice of medication. Results shown below reflect the health outcomes/medication attributes that were ranked "very important" by patients.

Outcome measures

Outcome measures
Measure	Aims 1, 2B, and 3 Groups n=25 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Serious Infection	2 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Being admitted	2 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Pancreatitis	3 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Issues with your feet	4 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Eye Issues	4 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Worsening Kidney Function	4 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Very low blood sugar	4 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Cancer	7 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Vessel Blockages	7 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Stroke	7 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Amputation	10 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Heart Attack	10 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes End Stage Kidney Disease (ESKD)	11 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Death	12 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Heart Failure	13 Participants
Patient Preferences for Second-line Type 2 Diabetes Medication Treatment Outcomes Blindness	16 Participants

SECONDARY outcome

Timeframe: Retrospective Data between 1/1/2014 - 12/31/2022, up to 8 years, collected over a 2-year period

The probability of a non-fatal MI experienced by subjects treated with DPP4i, GLP-1RA, SGLT2i, or Sulfonylureas (SU). The probability was calculated and reported as the hazard ratio.

Outcome measures

Outcome measures
Measure	Aims 1, 2B, and 3 Groups n=380352 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea
Non-fatal Myocardial Infarction (MI) GLP-1RA versus DPP4i	0.89 Hazard Ratio Interval 0.78 to 1.01
Non-fatal Myocardial Infarction (MI) SGLT2i versus DPP4i	0.93 Hazard Ratio Interval 0.85 to 1.02
Non-fatal Myocardial Infarction (MI) SU versus DPP4i	1.21 Hazard Ratio Interval 1.15 to 1.26
Non-fatal Myocardial Infarction (MI) SGLT2i versus GLP-1RA	1.05 Hazard Ratio Interval 0.91 to 1.21
Non-fatal Myocardial Infarction (MI) SU versus GLP-1RA	1.35 Hazard Ratio Interval 1.2 to 1.53
Non-fatal Myocardial Infarction (MI) SU versus SGLT2i	1.30 Hazard Ratio Interval 1.19 to 1.41

SECONDARY outcome

Timeframe: Retrospective Data between 1/1/2014 - 12/31/2022, up to 8 years, collected over a 2-year period

The probability of non-fatal stroke events experienced by subjects treated with DPP4i, GLP-1RA, SGLT2i, or Sulfonylureas (SU). The probability was calculated and reported as the hazard ratio.

Outcome measures

Outcome measures
Measure	Aims 1, 2B, and 3 Groups n=380352 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea
Non-fatal Stroke Events GLP-1RA versus DPP4i	0.89 Hazard Ratio Interval 0.78 to 1.02
Non-fatal Stroke Events SGLT2i versus DPP4i	0.89 Hazard Ratio Interval 0.81 to 0.98
Non-fatal Stroke Events SU versus DPP4i	1.18 Hazard Ratio Interval 1.13 to 1.24
Non-fatal Stroke Events SGLT2i versus GLP-1RA	1.00 Hazard Ratio Interval 0.86 to 1.16
Non-fatal Stroke Events SU versus GLP-1RA	1.33 Hazard Ratio Interval 1.17 to 1.5
Non-fatal Stroke Events SU versus SGLT2i	1.33 Hazard Ratio Interval 1.22 to 1.45

SECONDARY outcome

Timeframe: Retrospective Data between 1/1/2014 - 12/31/2022, up to 8 years, collected over a 2-year period

The probability of all-cause mortality events experienced by subjects treated with DPP4i, GLP-1RA, SGLT2i, Sulfonylureas (SU). The probability was calculated and reported as the hazard ratio.

Outcome measures

Outcome measures
Measure	Aims 1, 2B, and 3 Groups n=380352 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea
All-cause Mortality GLP-1RA versus DPP4i	0.86 Hazard Ratio Interval 0.78 to 0.94
All-cause Mortality SGLT2i versus DPP4i	0.79 Hazard Ratio Interval 0.73 to 0.85
All-cause Mortality SU versus DPP4i	1.22 Hazard Ratio Interval 1.18 to 1.26
All-cause Mortality SGLT2i versus GLP-1RA	0.92 Hazard Ratio Interval 0.82 to 1.03
All-cause Mortality SU versus GLP-1RA	1.42 Hazard Ratio Interval 1.3 to 1.56
All-cause Mortality SU versus SGLT2i	1.55 Hazard Ratio Interval 1.44 to 1.66

SECONDARY outcome

Timeframe: Retrospective Data between 1/1/2014 - 12/31/2022, up to 8 years, collected over a 2-year period

The probability of emergency department visits or hospitalization for hypoglycemia experienced by subjects treated with DPP4i, GLP-1RA, SGLT2i, or Sulfonylurea (SU). The probability was calculated and reported as the hazard ratio.

Outcome measures

Outcome measures
Measure	Aims 1, 2B, and 3 Groups n=380352 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea
Severe Hypoglycemia GLP-1RA versus DPP4i	0.63 Hazard Ratio Interval 0.51 to 0.76
Severe Hypoglycemia SGLT2i versus DPP4i	0.56 Hazard Ratio Interval 0.46 to 0.68
Severe Hypoglycemia SU versus DPP4i	2.51 Hazard Ratio Interval 2.29 to 2.75
Severe Hypoglycemia SGLT2i versus GLP-1RA	0.90 Hazard Ratio Interval 0.7 to 1.16
Severe Hypoglycemia SU versus GLP-1RA	4.00 Hazard Ratio Interval 3.32 to 4.85
Severe Hypoglycemia SU versus SGLT2i	4.46 Hazard Ratio Interval 3.73 to 5.32

SECONDARY outcome

Timeframe: Retrospective Data between 1/1/2014 - 12/31/2022, up to 8 years, collected over a 2-year period

Population: 367452 total participants were analyzed. Those 367452 participants were further broken down into the following categories DPP4i (77042), GLP-1RA (42009), SGLT2i (53435), Sulfonylureas (SU) (194966), respectively.

The probability of a new diagnosis of stage 5 or end-stage kidney disease experienced by subjects treated with DPP4i, GLP-1RA, SGLT2i, or Sulfonylurea (SU). The probability was calculated and reported as the hazard ratio.

Outcome measures

Outcome measures
Measure	Aims 1, 2B, and 3 Groups n=367452 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea
Incident End-stage Kidney Disease SGLT2i versus DPP4i	0.65 Hazard Ratio Interval 0.56 to 0.76
Incident End-stage Kidney Disease GLP-1RA versus DPP4i	0.81 Hazard Ratio Interval 0.66 to 0.99
Incident End-stage Kidney Disease SU versus DPP4i	1.01 Hazard Ratio Interval 0.93 to 1.08
Incident End-stage Kidney Disease SGLT2i versus SU	0.65 Hazard Ratio Interval 0.56 to 0.75
Incident End-stage Kidney Disease GLP-1RA versus SU	0.80 Hazard Ratio Interval 0.66 to 0.97
Incident End-stage Kidney Disease SGLT2i versus GLP-1RA	0.81 Hazard Ratio Interval 0.64 to 1.02

SECONDARY outcome

Timeframe: Retrospective Data between 1/1/2014 - 12/31/2022, up to 8 years, collected over a 2-year period

Population: 371698 total participants were analyzed. Those 371698 participants were further broken down into the following categories DPP4i (78444), GLP-1RA (42265), SGLT2i (53476), Sulfonylureas (SU) (197513), respectively.

The probability of treatment for diabetic retinopathy and/or macular edema experienced by subjects treated with DPP4i, GLP-1RA, SGLT2i, or Sulfonylurea (SU). The probability was calculated and reported as the hazard ratio.

Outcome measures

Outcome measures
Measure	Aims 1, 2B, and 3 Groups n=371698 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea
Treatment for Diabetic Retinopathy or Macular Edema SGLT2i versus GLP-1RA	0.73 Hazard Ratio Interval 0.55 to 0.97
Treatment for Diabetic Retinopathy or Macular Edema SGLT2i versus DPP4i	0.79 Hazard Ratio Interval 0.64 to 0.97
Treatment for Diabetic Retinopathy or Macular Edema SGLT2i versus SU	0.61 Hazard Ratio Interval 0.5 to 0.74
Treatment for Diabetic Retinopathy or Macular Edema GLP-1RA versus DPP4i	1.07 Hazard Ratio Interval 0.85 to 1.35
Treatment for Diabetic Retinopathy or Macular Edema GLP-1RA versus SU	0.83 Hazard Ratio Interval 0.67 to 1.03
Treatment for Diabetic Retinopathy or Macular Edema SU versus DPP4i	1.29 Hazard Ratio Interval 1.17 to 1.42

SECONDARY outcome

Timeframe: Retrospective Data between 1/1/2014 - 12/31/2022, up to 8 years, collected over a 2-year period

Population: 384451 total participants were analyzed. Those 384451 participants were further broken down into the following categories DPP4i (83937), GLP-1RA (43947), SGLT2i (46926), Sulfonylureas (SU) (209641), respectively.

The probability of foot and/or leg amputation, osteomyelitis, ulcer, abscess or Charcot arthropathy experienced by subjects treated with DPP4i, GLP-1RA, SGLT2i, or Sulfonylurea (SU). The probability was calculated and reported as the hazard ratio.

Outcome measures

Outcome measures
Measure	Aims 1, 2B, and 3 Groups n=384451 Participants De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea
Lower Extremity Complications SU versus DPP4i	1.15 Hazard Ratio Interval 1.11 to 1.19
Lower Extremity Complications SU versus GLP-1RA	1.20 Hazard Ratio Interval 1.13 to 1.28
Lower Extremity Complications SU versus SGLT2i	1.08 Hazard Ratio Interval 1.02 to 1.14
Lower Extremity Complications SGLT2i versus GLP-1RA	1.11 Hazard Ratio Interval 1.03 to 1.21
Lower Extremity Complications GLP-1RA versus DPP4i	0.96 Hazard Ratio Interval 0.89 to 1.02
Lower Extremity Complications SGLT2i versus DPP4i	1.07 Hazard Ratio Interval 1.0 to 1.13

Adverse Events

Aims 1, 2B, and 3 Groups

Serious events: 40642 serious events

Other events: 62982 other events

Deaths: 22208 deaths

Aim 2A Group

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure	Aims 1, 2B, and 3 Groups n=386276 participants at risk De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea	Aim 2A Group n=25 participants at risk Adults with Type 2 diabetes treated with one or more of the study medications (GLP-1RA, SGLT2i, DPP-4i, or SU) and not treated with insulin who received medical care at Mayo Clinic Rochester or Mayo Clinic Health System in Minnesota or Wisconsin. This arm was not exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were applicable as this arm collected prospective data.
Cardiac disorders Acute MI	2.9% 11372/386276 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.	0.00% 0/25 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.
Nervous system disorders Acute Stroke	2.8% 10647/386276 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.	0.00% 0/25 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.
Cardiac disorders Heart Failure Hospitalization	2.7% 10455/386276 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.	0.00% 0/25 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.
Renal and urinary disorders Chronic Kidney Disease Stage 5 or ESKD	2.4% 9216/386276 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.	0.00% 0/25 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.
Metabolism and nutrition disorders Hypoglycemia	1.1% 4282/386276 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.	0.00% 0/25 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.
Injury, poisoning and procedural complications Amputation	1.2% 4661/386276 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.	0.00% 0/25 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.

Other adverse events

Other adverse events
Measure	Aims 1, 2B, and 3 Groups n=386276 participants at risk De-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D) were utilized to identify adults (≥21 years) with T2D (established using validated Healthcare Effectiveness Data and Information Set criteria) who first filled any study drug GLP-1RA, SGLT2i, DPP-4i, or SU between 1/1/2014-12/31/2021. The arm was exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were not applicable as this arm used deidentified administrative claims data. Glucagon like peptide 1 receptor agonist: Patients in the data who filled a glucagon-like peptide-1 receptor agonist medication Sodium-glucose cotransporter 2 inhibitor: Patients in the data who filled a sodium-glucose cotransporter 2 inhibitor Dipeptidyl Peptidase 4 Inhibitor: Patients in the data who filled a dipeptidyl peptidase-4 inhibitor Sulfonylurea: Patients in the data who filled a sulfonylurea	Aim 2A Group n=25 participants at risk Adults with Type 2 diabetes treated with one or more of the study medications (GLP-1RA, SGLT2i, DPP-4i, or SU) and not treated with insulin who received medical care at Mayo Clinic Rochester or Mayo Clinic Health System in Minnesota or Wisconsin. This arm was not exempt from Mayo Clinic Institutional Review Board review and informed consent requirements were applicable as this arm collected prospective data.
Cardiac disorders Revascularization Procedure	11.0% 42514/386276 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.	0.00% 0/25 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.
Injury, poisoning and procedural complications Lower Extremity Complication	5.6% 21466/386276 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.	0.00% 0/25 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.
Eye disorders Treatment for Retinopathy	1.3% 4934/386276 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.	0.00% 0/25 • Aims 1, 2B, and 3 Groups: Adverse events were collected from the time of first observed use of one of the four study medications (DPP4i, GLP-1RA, SGLT2i, Sulfonylurea) during the study period until either the end of the study, disenrollment from insurance plans in our database, or death (approximately 8 years), retrospective data collected over a 2-year period. Aim 2A Group: Adverse events were collected from the time of informed consent through study completion, approximately 1 hour. Aims 1, 2B, and 3 Groups: Adverse events were collected through de-identified administrative claims with linked laboratory results, electronic health record (EHR), and mortality data from the OptumLabs Data Warehouse (OLDW) and Medicare fee-for-service data (Medicare parts A, B, D). Aims 2A Group: Adverse events were collected through patient interviews.

Additional Information

Rozalina McCoy, M.D., M.S.

Mayo Clinic

Phone: 507-538-7955

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place