Cardiometabolic risk reductions in patients with type 2 diabetes mellitus newly treated with a sodium-glucose cotransporter 2 inhibitor versus a dipeptidyl peptidase-4 inhibitor: A real-world administrative database study in Japan.

Autor: Kashiwagi A; Department of Diabetes and Endocrinology, Omi Medical Center, Shiga, Japan., Shoji S; Medical Affairs, Astellas Pharma Inc., Tokyo, Japan., Kosakai Y; Medical Affairs, Astellas Pharma Inc., Tokyo, Japan., Koga T; Clinical Research Professionals, Clinical Study Support, Inc., Nagoya, Japan., Asakawa K; Medical Affairs, Astellas Pharma Inc., Tokyo, Japan., Rokuda M; Medical Affairs, Astellas Pharma Inc., Tokyo, Japan.
Jazyk: angličtina
Zdroj: Journal of diabetes investigation [J Diabetes Investig] 2023 Mar; Vol. 14 (3), pp. 404-416. Date of Electronic Publication: 2022 Dec 14.
DOI: 10.1111/jdi.13952
Abstrakt: Aims/introduction: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown beneficial effects on cardiometabolic risk factors (hemoglobin A1c, body mass index, systolic blood pressure) in patients with type 2 diabetes mellitus. We compared combined cardiometabolic effects of SGLT2i on hemoglobin A1c, body mass index and systolic blood pressure versus dipeptidyl peptidase-4 inhibitors (DPP4i) in Japanese patients with type 2 diabetes mellitus.
Materials and Methods: This Japanese retrospective cohort study used the JMDC claims database. Patients newly treated with an SGLT2i (n = 18,936) or DPP4i (n = 55,484) were enrolled (January 2015-March 2020) and matched 1:1 using the propensity score. The primary end-point was the proportion of patients achieving a composite outcome (i.e., simultaneous absolute/percent reduction in hemoglobin A1c ≥0.5%, body mass index ≥3% and systolic blood pressure ≥2 mmHg) 1 year after first SGLT2i or DPP4i prescription; Mantel-Haenszel common risk difference and its 95% confidence interval were estimated. Other end-points included treatment persistence, with the associated hazard ratio calculated using the Cox proportional hazards model.
Results: After matching, patient characteristics were balanced (7,302 patients each). The proportion of patients achieving the composite outcome was significantly greater in patients receiving an SGLT2i than those receiving a DPP4i (31.0% [1,279/4,120] vs 12.9% [524/4,070], risk difference 18.6%, 95% confidence interval 16.3, 20.9, P < 0.001). Risk of treatment discontinuation was significantly lower in the SGLT2i group than in the DPP4i group (hazard ratio 0.85, 95% confidence interval 0.81, 0.90, P < 0.001).
Conclusions: In the present study, SGLT2i showed favorable cardiometabolic risk reduction and longer treatment persistence than DPP4i in Japanese patients with type 2 diabetes mellitus.
(© 2022 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje