Factors associated with DPP4i or SGLT2i utilisation: a retrospective cohort study among people with type 2 diabetes mellitus

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research Pub Date : 2024-12-09 DOI:10.1002/jppr.1951

Ruth Sim BPharm, Chun Wie Chong PhD, Navin Kumar Loganadan PhD, Noor Lita Adam MBBCh, Zanariah Hussein MBBS, Shaun Wen Huey Lee PhD

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引用次数: 0

Abstract

Background

Dipeptidyl peptidase-4 inhibitors (DPP4i) and sodium-glucose co-transporter 2 inhibitors (SGLT2i) are increasingly used as glucose-lowering therapies in Malaysia.

Aim

To examine factors associated with the initiation of DPP4i or SGLT2i among people with type 2 diabetes mellitus (T2DM) in Malaysia.

Method

A retrospective cohort study was conducted from 1 January 2012–30 December 2020 in two tertiary Malaysian hospitals. Multivariate logistic regression was used to assess the factors associated with DPP4i or SGLT2i initiation. The impact of treatment initiation on glycaemic control, anthropometric and lipid levels at 6 and 12 months were also measured. Ethical approval was granted by the Malaysian National Medical Research Register (Reference no: NMRR-20-662-52570), the Monash University Human Research Ethics Committee (Reference no: 2020-24900-45575), the Ministry of Health Malaysia Medical Research and Ethics Committee, and the study conforms with the Declaration of Helsinki.

Results

This study included 1628 patients. Patients with co-existing dyslipidaemia (odds ratio [OR] 1.34, 95% confidence interval [CI] 1.04–1.73), cardiovascular disease (OR 1.43, 95% CI 1.1–1.87), and microalbuminuria (OR 2.47, 95% CI 1.42–4.3), with ≥5-year history of T2DM (years of T2DM 5–14 OR 1.67, 95% CI1.18–2.38; years of T2DM ≥15 OR 2.07, 95% CI 1.39–3.07), who had a body weight of ≥100 kg (OR 1.75, 95% CI 1.26–2.45), and baseline use of three or more glucose-lowering medicines (OR 2.92, 95% CI 1.74–4.91) had higher odds of being prescribed with SGLT2i. Patients aged ≥65 years old (OR 0.68, 95% CI 0.50–0.93), presented with a family history of diabetes (OR 0.64, 95% CI 0.47–0.89), an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m² (eGFR 60–89 mL/min/1.73 m² OR 0.60, 95% CI 0.39–0.90; eGFR ≥90 mL/min/1.73 m² OR 0.55, 95% CI 0.34–0.87), with serum creatinine ≥120 μmol/L (OR 0.31, 95% CI 0.17–0.58), and had baseline usage of sulfonylureas (OR 0.28, 95% CI 0.19–0.4) and insulin (OR 0.5, 95% CI 0.35–0.72) were more likely to receive DPP4i. Glycated haemoglobin of patients receiving these medicines reduced significantly at 6 months (DPP4i: −0.61%, p < 0.001; SGLT2i: −0.66%, p < 0.001) and 12 months (DPP4i: −0.62%, p < 0.001; SGLT2i: −0.74%, p < 0.001).

Conclusion

Treatment choice with pharmacotherapy was associated with many clinical risk factors presented by patients.

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来源期刊

Journal of Pharmacy Practice and Research Health Professions-Pharmacy

CiteScore

1.60

自引率

9.50%

发文量

期刊介绍： The purpose of this document is to describe the structure, function and operations of the Journal of Pharmacy Practice and Research, the official journal of the Society of Hospital Pharmacists of Australia (SHPA). It is owned, published by and copyrighted to SHPA. However, the Journal is to some extent unique within SHPA in that it ‘…has complete editorial freedom in terms of content and is not under the direction of the Society or its Council in such matters…’. This statement, originally based on a Role Statement for the Editor-in-Chief 1993, is also based on the definition of ‘editorial independence’ from the World Association of Medical Editors and adopted by the International Committee of Medical Journal Editors.