Third-Line Antidiabetic Therapy Intensification Patterns and Glycaemic Control in Patients with Type 2 Diabetes in the USA: A Real-World Study

Drugs
Digsu N KoyeSanjoy K Paul

Abstract

Third-line antidiabetic drug (ADD) intensification patterns and glycemic control post intensification in type 2 diabetes mellitus (T2DM) have not been thoroughly explored in a real-world setting. This study explored the patterns and risks of third-line ADD intensification post second-line ADDs and the probability of desirable glucose control over 12 months by third-line ADD classes at the population level. We used the electronic medical records of 255,236 patients with T2DM in the USA initiating a second-line ADD post metformin from January 2013 to evaluate the rates and risks of third-line intensification and the probability of desirable glycemic control with different ADDs after addressing inherent heterogeneity using appropriate methodologies. Patients had a mean age of 60 years and glycated hemoglobin (HbA1c) of 8.5% at second-line ADD. Over 209,136 person-years (PY) of follow-up, 40% had initiated a third-line ADD at HbA1c of 8.8%. Patients receiving dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) as the second-line ADD had a 7% (95% hazard ratio [HR] confidence interval [CI] 1.05-1.10) and 28% (95% HR CI 1.24-1.33) higher adjusted risk of intensifying with a third-line ...Continue Reading

References

Apr 26, 2014·Journal of Managed Care Pharmacy : JMCP·Philip A LevinOnur Baser
Oct 28, 2014·JAMA Internal Medicine·Jodi B Segal, Nisa M Maruthur
Aug 13, 2017·Diabetes Care·Steven V Edelman, William H Polonsky
Aug 24, 2017·Diabetes, Obesity & Metabolism·Kamlesh KhuntiJesús Medina
Dec 8, 2017·Diabetology & Metabolic Syndrome·Yotsapon ThewjitcharoenThep Himathongkam

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