在美国真实环境中，新开始口服semaglutide与DPP-4is的2型糖尿病患者的依从性和持续性。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes Pub Date : 2024-07-10 DOI:10.1016/j.pcd.2024.06.013

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引用次数: 0

摘要

目的：调查新开始口服semaglutide、胰高血糖素样肽-1受体激动剂（GLP-1 RA）或二肽基肽酶-4抑制剂（DPP-4i）的2型糖尿病患者的实际治疗依从性和持续性：这项回顾性队列研究使用了 Merative™ MarketScan® 商业和医疗保险数据库。索引日期为队列药物的首次服用日期。依从性定义为指数后 12 个月内的覆盖天数比例 (PDC)（"依从性" = ≥0.8）。持续性是指停药前的天数，以 45 天的间隔为基础。采用反概率治疗加权法对各组间的结果进行比较：口服塞马鲁肽（n=5485）和DPP-4i（n=4980）队列中坚持治疗（PDC≥0.8；41.6% vs. 42.9%；P=0.182）和坚持治疗≥9个月（45.0% vs. 46.3%；P=0.185）的人数比例相似。DPP-4i队列在指数后期间使用的抗糖尿病药物（ADM）种类明显更多（平均值±SD：2.6±1.0 vs. 2.9±1.1，P <0.001），其中23.2%在指数后期间服用了GLP-1 RA：各组患者的依从性和持续性相似。然而，与 DPP-4is 相比，口服塞马鲁肽有潜在的益处，包括减少对额外 ADM 的需求。

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Adherence and persistence among people with type 2 diabetes newly initiating oral semaglutide versus DPP-4is in a US real-world setting

Aims

To investigate real-world treatment adherence and persistence in people with type 2 diabetes newly initiating oral semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), or a dipeptidyl peptidase-4 inhibitor (DPP-4i).

Methods

This retrospective cohort study used the Merative™ MarketScan® Commercial and Medicare databases. Index date was the first fill for the cohort medication. Adherence was defined as proportion of days covered (PDC) over the 12-month post-index period (‘adherent’ = ≥0.8). Persistence was number of days until discontinuation, based on a 45-day gap. Results were compared between cohorts using inverse probability treatment weighting.

Results

Oral semaglutide (n=5485) and DPP-4i (n=4980) cohorts had similar percentages of people who were adherent (PDC ≥0.8; 41.6 % vs. 42.9 %; P = 0.182) and persistent for ≥9 months (45.0 % vs. 46.3 %; P = 0.185). The DPP-4i cohort used significantly more anti-diabetic medication (ADM) classes over the post-index period (mean±SD: 2.6±1.0 vs. 2.9±1.1, P < 0.001), with 23.2 % filling a GLP-1 RA in the post-period.

Conclusions

Adherence and persistence were similar between cohorts. However, there are potential benefits to prescribing oral semaglutide over DPP-4is, including reduced need for additional ADM.

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来源期刊

Primary Care Diabetes ENDOCRINOLOGY & METABOLISM-PRIMARY HEALTH CARE

CiteScore

5.00

自引率

3.40%

发文量

134

审稿时长

47 days

期刊介绍： The journal publishes original research articles and high quality reviews in the fields of clinical care, diabetes education, nutrition, health services, psychosocial research and epidemiology and other areas as far as is relevant for diabetology in a primary-care setting. The purpose of the journal is to encourage interdisciplinary research and discussion between all those who are involved in primary diabetes care on an international level. The Journal also publishes news and articles concerning the policies and activities of Primary Care Diabetes Europe and reflects the society''s aim of improving the care for people with diabetes mellitus within the primary-care setting.