开始GLP-1受体激动剂治疗的2型糖尿病和慢性肾病患者的临床概况和治疗模式:一项多国队列研究

IF 3.8 3区 医学 Q2 Medicine
Manel Pladevall-Vila, Ryan Ziemiecki, Catherine B Johannes, Anam M Khan, Daniel Mines, 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

摘要

导论:预防2型糖尿病(T2D)患者慢性肾脏疾病(CKD)进展的新疗法正在出现。在FOUNTAIN平台内(NCT05526157;EUPAS48148),这项真实世界的研究旨在描述2012-2021年在欧洲、日本和美国(US)开始使用胰高血糖素样肽-1受体激动剂(GLP-1 RA)治疗的CKD和T2D成人队列。方法:这项跨国、多队列研究在五个数据源中进行:丹麦国家健康登记处(DNHR)(丹麦)、PHARMO数据网络(PHARMO)(荷兰)、瓦伦西亚卫生系统集成数据库(VID)(西班牙)、日本慢性肾病数据库扩展(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T2D(由数据源特定算法定义)和CKD(基于诊断代码、估计肾小球滤过率值和/或尿白蛋白与肌酐比值),并在2012-2021年期间开始GLP-1 RA治疗。分析了基线人口统计学、生活方式和临床特征,并描述了治疗模式。结果:研究队列包括18,929例DNHR GLP-1 RA启动者;药学研究476例;VID为11,798;J-CKD-DB-Ex蛋白329;清洁发展机制为70158个。在所有队列中,J-CKD-DB-Ex患者的平均年龄从66.1岁到CDM患者的67.9岁不等,46.6% (PHARMO)和59.6% (J-CKD-DB-Ex)患者为男性。从2012年(1.6-4.8%的GLP-1 RA启动剂开始治疗)到2019年(19.8-31.5%开始治疗),GLP-1 RA启动剂的数量稳步增加。GLP-1 RA初始治疗的中位持续时间从2.3个月(PHARMO)到12.4个月(VID)不等。在1年随访中,52% (CDM)和78% (DNHR)的患者接受了治疗。研究结果表明GLP-1 RA的使用与CKD严重程度无关。结论:在2012-2021年期间,跨国T2D和CKD患者队列中GLP-1 RA的使用稳步增加,并且治疗的持久性很高。GLP-1的使用与CKD严重程度无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Profile and Treatment Patterns in Individuals with Type 2 Diabetes and Chronic Kidney Disease Who Initiate a GLP-1 Receptor Agonist: A Multinational Cohort Study.

Introduction: Novel therapies are emerging for the prevention of chronic kidney disease (CKD) progression in patients with type 2 diabetes (T2D). Within the FOUNTAIN platform (NCT05526157; EUPAS48148), this real-world study aimed to characterize cohorts of adults with CKD and T2D starting therapy with a glucagon-like peptide-1 receptor agonist (GLP-1 RA) in Europe, Japan, and the United States (US) during 2012-2021.

Methods: This multinational, multicohort study was conducted in five data sources: the Danish National Health Registers (DNHR) (Denmark), PHARMO Data Network (PHARMO) (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 T2D (defined by data source-specific algorithms) and CKD (based on diagnosis codes, estimated glomerular filtration rate values, and/or urine albumin-to-creatinine ratio) and initiated an GLP-1 RA during 2012-2021. Baseline demographic, lifestyle, and clinical characteristics were analyzed, and treatment patterns were described.

Results: Study cohorts included 18,929 GLP-1 RA initiators in DNHR; 476 in PHARMO; 11,798 in VID; 329 in J-CKD-DB-Ex; and 70,158 in CDM. Across cohorts, mean age ranged from 66.1 years in J-CKD-DB-Ex to 67.9 years in CDM, and between 46.6% (PHARMO) and 59.6% (J-CKD-DB-Ex) of patients were men. There was a steady increase in GLP-1 RA initiators from 2012 (when 1.6-4.8% of GLP-1 RA initiators started therapy) to 2019 (when 19.8-31.5% started therapy). The median duration of initial treatment with a GLP-1 RA ranged from 2.3 months (PHARMO) to 12.4 months (VID). At 1-year follow-up, between 52% (CDM) and 78% (DNHR) of patients were receiving treatment. Findings suggested that GLP-1 RA use was independent of CKD severity.

Conclusions: During 2012-2021, GLP-1 RA use steadily increased across multinational cohorts of patients with T2D and CKD, and persistence with treatment was high. GLP-1 use was independent of CKD severity.

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来源期刊
Diabetes Therapy
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.
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