Use of Potentially Nephrotoxic Drugs in Type 2 Diabetes Patients on SGLT2i: A Trajectories Analysis.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2025-02-01 DOI:10.1002/pds.70098

Lanting Yang, Jingchuan Guo, Sandra L Kane-Gill, Nico Gabriel, Kerry M Empey, Kangho Suh, Levent Kirisci, Inmaculada Hernandez

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引用次数: 0

Abstract

Purpose: To characterize trajectories of nephrotoxic potential (NxP) drug use among older adults with Type 2 Diabetes (T2D) treated with SGLT2is and identify associated patient characteristics.

Methods: Using 2012-2019 Medicare data, we selected patients with T2D who filled at least one prescription for SGLT2is. Index date was the date of the first SGLT2i prescription filled. We quantified the number of drugs with NxP used every month during the first 12 months following the index date. The monthly counts of drugs with NxP were incorporated into the group-based trajectory model to identify groups with similar drug use patterns. Finally, we performed a multinomial logistic regression model to examine the association between patient characteristics and group membership.

Results: The study cohort comprised 8811 Medicare beneficiaries with T2D who initiated SGLT2i during the study period with the mean age 67.5 ± 10.6 years. We identified 3 trajectories NxP drug use: no (n = 2142, 24%), low (n = 4752, 54%) and high (n = 1917, 22%) use of drugs with NxP, with patients falling into these categories based on the number of drugs with NxP they used over the time: no drugs, one drug, or two or more drugs. Age, gender, low-income subsidy eligibility and clinical characteristics were associated with group membership.

Conclusions: We successfully identified three trajectory groups, with a substantial proportion of patients showing low use of drugs with NxP. Both social and clinical factors were associated with the use of NxP drugs.

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2型糖尿病SGLT2i患者使用潜在肾毒性药物：轨迹分析

目的：描述SGLT2is治疗的老年2型糖尿病（T2D）患者肾毒性潜能（NxP）药物使用轨迹，并确定相关患者特征。方法：使用2012-2019年的医疗保险数据，我们选择了至少服用一种SGLT2is处方的T2D患者。索引日期为第一张SGLT2i处方的配药日期。我们量化在索引日期后的前12个月内每月使用NxP药物的数量。将每月使用恩智浦药物的数量纳入基于组的轨迹模型，以识别具有相似药物使用模式的组。最后，我们进行了多项逻辑回归模型来检验患者特征与群体成员之间的关系。结果：研究队列包括8811名在研究期间开始SGLT2i的T2D医疗保险受益人，平均年龄为67.5±10.6岁。我们确定了3种恩智浦药物使用轨迹：没有（n = 2142, 24%），低（n = 4752, 54%）和高（n = 1917, 22%）使用恩智浦药物，患者根据他们在一段时间内使用恩智浦药物的数量分为这些类别：没有药物，一种药物，或两种或更多药物。年龄、性别、低收入补贴资格和临床特征与组成员有关。结论：我们成功地确定了三个轨迹组，其中相当大比例的患者表现出低恩智浦药物的使用。社会和临床因素都与恩智浦药物的使用有关。

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

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.