Concordance with prescribing information dosage recommendations for dipeptidyl-peptidase-4 inhibitors among type 2 diabetes mellitus patients with moderate to severe chronic kidney disease
| Autor: | Sharash Shetty, Huan Huang, Kathleen Lang, Elise Bauer |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Moderate to severe
Male medicine.medical_specialty Concordance 030209 endocrinology & metabolism Adamantane Linagliptin 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Prescribing information medicine Humans Hypoglycemic Agents Renal Insufficiency Chronic Dipeptidyl peptidase-4 Aged Retrospective Studies Aged 80 and over Dipeptidyl-Peptidase IV Inhibitors business.industry Sitagliptin Phosphate Type 2 Diabetes Mellitus General Medicine Dipeptides Middle Aged medicine.disease Diabetes Mellitus Type 2 Female business Kidney disease |
| Zdroj: | Current medical research and opinion. 34(6) |
| ISSN: | 1473-4877 |
| Popis: | To estimate the proportion of patients with moderate to severe chronic kidney disease (CKD) whose initial dipeptidyl-peptidase-4 inhibitor (DPP4-i) dosage was concordant with prescribing information (label) recommendations in the United States.Adult patients with type 2 diabetes mellitus (T2DM) who initiated a DPP4-i (linagliptin, sitagliptin, saxagliptin) between 1 January 2011 and 30 June 2014 were identified using electronic medical records and administrative claims, with index date being the date of first observed DPP4-i treatment. Patients were required to have chronic kidney disease (CKD) stage 3b, 4 or 5 (estimated Glomerular Filtration Rate [eGFR] value45 ml/min/1.73 mOf the 492 patients (323 sitagliptin, 57 saxagliptin, 112 linagliptin), 36.2% were prescribed doses that were not concordant with label recommendations (44.9% for sitagliptin, 57.9% for saxagliptin and 0% for linagliptin [which does not require dosage adjustment]). Concordant patients were slightly older (mean age 71 years vs. 68, p = .01) but had similar gender distribution (55% vs. 60% female, p = .31) compared to those who were not concordant. They had lower general health status (Charlson Comorbidity Score 2.6 vs. 2.2, p = .03), and had similar pre-index all-cause total costs ($25,245 vs. $21,972, p = .68) and lower pre-index T2DM-related costs ($1618 vs. $1922, p = .05).More than a third of DPP4-i patients with CKD stage 3b or higher were prescribed doses not concordant with DPP4-i label dosage recommendations. |
| Databáze: | OpenAIRE |
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