OW GLP-1 RAs和其他降糖治疗在T2D和ASCVD患者中的比较效果

IF 7.4 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Xi Tan , Joanna Harton , Cynthia Gutierrez , Yuanjie Liang , Lin Xie , Chalak Muhammad , Caroline Swift , Adam de Havenon
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引用次数: 0

摘要

目的:比较每周一次(OW)胰高血糖素样肽-1受体激动剂(GLP-1 RAs)治疗与其他非胰岛素降糖治疗(oniglt)患者心血管(CV)结局、医疗资源利用(HCRU)和成本的发生率。方法:这是一项观察性队列研究,使用医疗保险按服务收费索赔数据(2006-2022)。使用OW GLP-1 RAs或oniglt治疗的T2D和ASCVD的医疗保险受益人使用倾向评分匹配进行匹配。结果:在总共398,470名医疗保险受益人中,OW GLP-1 RAs与降低CV事件风险相关(风险比[hr]范围:0.72至0.88,P )结论:研究结果证实了目前指南中对T2D和ASCVD患者GLP-1 RAs的推荐,并将研究结果扩展到现实世界中HCRU和成本的降低,最明显的是semaglutide。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative effectiveness of OW GLP-1 RAs and other glucose-lowering therapies among Medicare beneficiaries with T2D and ASCVD

Aims

To compare the incidence rates for cardiovascular (CV) outcomes and healthcare resource utilization (HCRU) and costs among patients treated with once-weekly (OW) glucagon-like peptide-1 receptor agonists (GLP-1 RAs) compared with other non-insulin glucose lowering therapies (ONIGLTs).

Methods

This was an observational cohort study using Medicare fee-for-service claims data (2006–2022). Medicare beneficiaries with T2D and ASCVD treated with OW GLP-1 RAs or ONIGLTs were matched using propensity score matching.

Results

Among the total 398,470 Medicare beneficiaries, OW GLP-1 RAs were associated with reduced risk of CV events (hazard ratios [HRs] range: 0.72 to 0.88, P < 0.05 for all) compared with ONIGLTs, in addition to lower HCRU and costs including ASCVD-related total medical visits (incidence rate ratio [95 % CI]: 0.91 [0.90–0.93]; P < 0.001) and total medical costs (mean cost ratio [95 %CI]: 0.88 [0.86–0.91]; P < 0.001). Among OW GLP-1 RAs, semaglutide had the lowest risk of all CV outcomes when compared with SGLT2is (HRs range: 0.80 to 0.85, P < 0.05 for all) and DPP-4is (HRs range: 0.58 to 0.73; P < 0.001 for all).

Conclusion

The study findings corroborate current guideline recommendations for GLP-1 RAs in people with T2D and ASCVD, and extend findings to lower HCRU and costs in a real-world setting, most notably for semaglutide.
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来源期刊
Diabetes research and clinical practice
Diabetes research and clinical practice 医学-内分泌学与代谢
CiteScore
10.30
自引率
3.90%
发文量
862
审稿时长
32 days
期刊介绍: Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.
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