Clinical Profile and Treatment Adherence in Patients with Type 2 Diabetes and Chronic Kidney Disease Who Initiate an SGLT2 Inhibitor: A Multi-cohort Study.

IF 3.8 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2025-02-01 Epub Date: 2024-12-17 DOI:10.1007/s13300-024-01671-x

Catherine B Johannes, Ryan Ziemiecki, Manel Pladevall-Vila, Natalie Ebert, Csaba P Kovesdy, Reimar W Thomsen, Brenda N Baak, Aníbal García-Sempere, Hiroshi Kanegae, Craig I Coleman, Michael Walsh, Ina Trolle Andersen, Clara Rodríguez Bernal, Celia Robles Cabaniñas, Christian Fynbo Christiansen, Alfredo E Farjat, Alain Gay, Patrick Gee, Ron M C Herings, Isabel Hurtado, Naoki Kashihara, Frederik Pagh Bredahl Kristensen, Fangfang Liu, Suguru Okami, Jetty A Overbeek, Fernie J A Penning-van Beest, Satoshi Yamashita, Yuichiro Yano, J Bradley Layton, David Vizcaya, Nikolaus G Oberprieler

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引用次数: 0

Abstract

Introduction: The clinical landscape for the treatment of patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) is rapidly evolving. As part of the FOUNTAIN platform (NCT05526157; EUPAS48148), we described and compared cohorts of adult patients with CKD and T2D initiating a sodium-glucose cotransporter 2 inhibitor (SGLT2i) before the launch of finerenone in Europe, Japan, and the United States (US).

Methods: This was a multinational, multi-cohort study of patients with T2D in five data sources: the Danish National Health Registers (DNHR) (Denmark), PHARMO Data Network (The Netherlands), Valencia Health System Integrated Database (VID) (Spain), Japan Chronic Kidney Disease Database Extension (J-CKD-DB-Ex) (Japan), and Optum's de-identified Clinformatics^® Data Mart Database (CDM) (US). Eligible patients had CKD (based on either diagnosis codes, eGFR values, and/or urine ACR) and initiated an SGLT2i between 2012 and 2021. Baseline demographic, lifestyle, and clinical characteristics were analyzed, and drug utilization patterns were described.

Results: The final cohorts included 21,739 patients in DNHR, 381 in PHARMO, 31,785 in VID, 1157 in J-CKD-DB-Ex, and 56,219 in CDM. Across data sources, approximately 41-70% had CKD stage 1 or 2 at baseline; severe CKD (stage 4) was uncommon (1.6-6.7%). The median duration of SGLT2i therapy ranged from 7.5 months in PHARMO to 17.0 months in VID. At least 50% of patients were currently receiving SGLT2i treatment at 1 year after initiation.

Conclusions: At a 1-year follow-up, at least half of the patients with CKD and T2D were receiving SGLT2i treatment across the data sources. In patients initiating SGLT2i, treatment options for T2D and CKD were heterogeneous and dynamic within and among data sources.

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开始服用 SGLT2 抑制剂的 2 型糖尿病和慢性肾病患者的临床概况和治疗依从性：一项多队列研究

慢性肾脏疾病（CKD）和2型糖尿病（T2D）患者治疗的临床前景正在迅速发展。作为FOUNTAIN平台(NCT05526157；EUPAS48148)，我们描述并比较了在芬烯酮在欧洲、日本和美国上市之前开始使用钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）的成年CKD和T2D患者队列。方法：这是一项跨国、多队列的T2D患者研究，涉及五个数据源：丹麦国家健康登记处（DNHR）（丹麦）、PHARMO数据网络（荷兰）、瓦伦西亚卫生系统集成数据库（VID）（西班牙）、日本慢性肾脏疾病数据库扩展（J-CKD-DB-Ex）（日本）和Optum的去识别Clinformatics®数据市场数据库（CDM）（美国）。符合条件的患者患有CKD（基于诊断代码、eGFR值和/或尿液ACR），并在2012年至2021年期间启动了SGLT2i。分析了基线人口统计学、生活方式和临床特征，并描述了药物利用模式。结果：最终的队列包括DNHR患者21,739例，PHARMO患者381例，VID患者31,785例，J-CKD-DB-Ex患者1157例，CDM患者56,219例。在数据来源中，大约41-70%的患者在基线时为CKD 1期或2期；严重CKD（4期）不常见（1.6-6.7%）。SGLT2i治疗的中位持续时间从PHARMO的7.5个月到VID的17.0个月不等。目前至少有50%的患者在开始治疗1年后接受SGLT2i治疗。结论：在1年的随访中，至少有一半的CKD和T2D患者接受了SGLT2i治疗。在启动SGLT2i的患者中，T2D和CKD的治疗方案在数据来源内部和不同数据源之间是异质性和动态的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.