Real-World Treatment Patterns Among Patients with Type 2 Diabetes Mellitus Initiating Treatment with Oral Semaglutide.

IF 3.8 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2024-07-01 Epub Date: 2024-05-09 DOI:10.1007/s13300-024-01589-4

Caroline Swift, Monica S Frazer, Noelle N Gronroos, Andrew Sargent, Michael Leszko, Erin Buysman, Sara Alvarez, Tyler J Dunn, Josh Noone, Mico Guevarra

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Abstract

Introduction: The treatment landscape for type 2 diabetes mellitus (T2DM) is complex and constantly evolving, and real-world evidence of prescribing patterns is limited. The objectives of this study were to characterize lines of therapy (LOTs), calculate the length of time spent on each LOT, and identify the reasons for the LOT end among patients who initiated oral semaglutide for T2DM.

Methods: This retrospective, claims-based study included commercial and Medicare Advantage adults with T2DM. Data from November 1, 2019, and June 30, 2020, were obtained from Optum Research Database. Patients with ≥ 1 claim for oral semaglutide and continuous health plan enrollment for ≥ 12 months prior to (baseline period) and ≥ 6 months following (follow-up period) the date of the first oral semaglutide claim were included. LOT 1 began on the date of the first oral semaglutide claim. The start date of any subsequent LOTs was the date of the first claim for an additional non-insulin anti-diabetic drug class or a reduction in drug class with use of commitment medications. The LOT ended at the first instance of medication class discontinuation, change in regimen or end of follow-up.

Results: Of the 1937 patients who initiated oral semaglutide, 950 (49.0%) remained on their initial regimen over the 6-month follow-up period, 844 (43.6%) had at least one subsequent LOT, and 89 (4.6%) had at least two subsequent LOTs. Among patients with more than one LOT, approximately 20%-25% used oral semaglutide as monotherapy or combination therapy during LOTs 2 and 3. Metformin was frequently used during treatment across all LOTs.

Conclusion: This study provides insight for physicians and payers into the real-world prescribing practices within the first 6 months following oral semaglutide initiation and fills the gap in understanding the frequency of regimen changes in the constantly evolving and complex environment of T2DM care.

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开始口服塞马鲁肽治疗的 2 型糖尿病患者的实际治疗模式。

简介：2 型糖尿病（T2DM）的治疗情况复杂且不断变化，而现实世界中有关处方模式的证据却很有限。本研究的目的是描述治疗方案（LOT）的特点，计算每种治疗方案所花费的时间，并确定开始口服司马鲁肽治疗 T2DM 的患者结束治疗方案的原因：这项基于理赔的回顾性研究纳入了患有 T2DM 的商业和医疗保险优势成人患者。数据来自 Optum 研究数据库，时间跨度为 2019 年 11 月 1 日至 2020 年 6 月 30 日。研究对象包括口服塞马鲁肽索赔次数≥1次，且在首次口服塞马鲁肽索赔日期之前（基线期）≥12个月和之后（随访期）≥6个月连续加入医疗保险的患者。LOT 1 从首次口服塞马鲁肽的申请日期开始。任何后续 LOT 的开始日期均为首次申请额外的非胰岛素抗糖尿病药物类别或减少药物类别并使用承诺药物的日期。LOT在首次停用药物类别、改变治疗方案或随访结束时终止：在 1937 名开始口服塞马鲁肽的患者中，950 人（49.0%）在 6 个月的随访期间仍在使用初始方案，844 人（43.6%）至少有一次后续 LOT，89 人（4.6%）至少有两次后续 LOT。在接受过一次以上LOT治疗的患者中，约有20%-25%的患者在第2次和第3次LOT治疗期间使用口服塞马鲁肽作为单一疗法或联合疗法。在所有LOT的治疗过程中，二甲双胍被频繁使用：本研究为医生和付款人提供了口服塞马鲁肽后头 6 个月内实际处方做法的见解，填补了在不断发展和复杂的 T2DM 护理环境中了解治疗方案变化频率的空白。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.