Comment on Suissa. Lower Risk of Death With SGLT2 Inhibitors in Observational Studies: Real or Bias? Diabetes Care 2018;41:6-10

Thuresson et al. commented on an article by Suissa regarding lower risk of death with sodium-glucose cotransporter 2 inhibitors (SGL2i) in observational studies. They agreed that the study offered important insights into the comparative effectiveness of therapeutic approaches and that such approaches could introduce an immortal time bias. They pursued additional sensitivity analyses in Sweden and Norway to examine whether such bias exists. They do not believe that the immortal time bias affected the results of the Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors (CVD-REAL) study in a substantive way.