Cardiovascular Events in Adults with Type 2 Diabetes and ASCVD Initiating Once-Weekly Semaglutide vs DPP-4is in the USA.

IF 3.8 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2025-02-01 Epub Date: 2024-12-17 DOI:10.1007/s13300-024-01678-4

Silvio E Inzucchi, Xi Tan, Yuanjie Liang, Larisa Yedigarova, Lin Xie, Adam de Havenon

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引用次数: 0

Abstract

Introduction: Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have demonstrated cardiovascular benefits in trials involving high-risk patients with type 2 diabetes (T2D), while dipeptidyl peptidase 4 inhibitors (DPP-4is) have not. However, DPP-4is are still commonly prescribed in patients with T2D and atherosclerotic cardiovascular disease (ASCVD). This study compared time to occurrence of cardiovascular events, health care resource utilization (HCRU), and medical costs in patients with T2D and ASCVD who initiated once-weekly semaglutide vs a DPP-4i.

Methods: Two separate observational cohort analyses were conducted using Optum's de-identified Clinformatics^® Data Mart Database (CDM) and Komodo Healthcare Map™ (January 1, 2018 to September 30, 2022). Patients had T2D and ASCVD and received semaglutide or a DPP-4i. Baseline characteristics were balanced using inverse probability of treatment weighting.

Results: After weighting, the CDM analysis included 14,461 semaglutide users and 38,630 DPP-4i users and the Komodo Healthcare Map analysis included 48,303 semaglutide users and 109,179 DPP-4i users. In CDM, semaglutide users had significantly decreased risk of stroke (hazard ratio [HR], 0.54), myocardial infarction (HR 0.64), and their composite (HR 0.59) vs DPP-4is. Semaglutide users also had fewer ASCVD-related and all-cause hospitalizations and outpatient visits and lower ASCVD-related and all-cause hospitalization and total medical costs. Results from Komodo Health were generally consistent with those from CDM.

Conclusion: Semaglutide users had significantly reduced risk of cardiovascular outcomes, HCRU, and medical costs compared with DPP-4is. This corroborates results from prior studies of once-weekly GLP-1 RAs and reinforces the important role of semaglutide treatment for patients with T2D and ASCVD. Graphical abstract available for this article.

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在美国，成人2型糖尿病和ASCVD患者的心血管事件开始每周一次的西马鲁肽与dpp -4

胰高血糖素样肽1受体激动剂（GLP-1 RAs）在高风险2型糖尿病（T2D）患者的试验中显示出心血管益处，而二肽基肽酶4抑制剂（DPP-4is）则没有。然而，dpp -4仍常用于T2D和动脉粥样硬化性心血管疾病（ASCVD）患者。本研究比较了T2D和ASCVD患者每周服用一次西马鲁肽和服用DPP-4i的心血管事件发生时间、医疗资源利用率（HCRU）和医疗费用。方法：使用Optum的去识别Clinformatics®数据集市数据库（CDM）和Komodo医疗保健地图™（2018年1月1日至2022年9月30日）进行了两项单独的观察性队列分析。患有T2D和ASCVD的患者接受了西马鲁肽或DPP-4i治疗。使用治疗加权的逆概率来平衡基线特征。结果：加权后，CDM分析包括14461名semaglutide用户和38630名DPP-4i用户，Komodo保健地图分析包括48303名semaglutide用户和109179名DPP-4i用户。在CDM中，与dpp -4相比，semaglutide使用者的卒中风险（危险比[HR]， 0.54）、心肌梗死风险（HR 0.64）及其综合风险（HR 0.59）显著降低。Semaglutide使用者的ascvd相关和全因住院和门诊次数也较少，ascvd相关和全因住院和总医疗费用也较低。Komodo Health的结果与CDM的结果基本一致。结论：与dpp -4相比，Semaglutide使用者心血管结局、HCRU和医疗费用的风险显著降低。这证实了先前每周一次GLP-1 RAs的研究结果，并强化了西马鲁肽治疗T2D和ASCVD患者的重要作用。本文提供图形摘要。

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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.