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Analysis of the Adherence and Safety of Second Oral Glucose-Lowering Therapy in Routine Practice From the Mediterranean Area: A Retrospective Cohort Study

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journal contribution
posted on 03.09.2021, 10:29 by Bogdan Vlacho, Manel Mata-Cases, Xavier Mundet-Tuduri, Joan-Antoni Valles-Callol, Jordi Real, Magi Farre, Xavier Cos, Kamlesh Khunti, Didac Mauricio, Josep Franch-Nadal
The aims of our study was compare adherence measured by the medical possession ratio (MPR), time until discontinuation and describe adverse events after adding a DPP-4i, SGLT-2i, or sulfonylureas (SU) to metformin in a primary care population with insufficient glycemic control. We used routinely-collected health data from the SIDIAP database. The included subjects were matched by propensity score. The follow-up period was up to 24 months or premature discontinuation. The primary outcomes were the percentage of subjects with good adherence, treatment discontinuation and adverse events among treatment groups. The proportion of patients with good adherence (MPR> 0.8) after the addition of DPP-4i, SGLT-2i or SU was 53.6%, 68.7%, and 43.0%, respectively. SGLT-2i users were 1.7 times more likely to achieve good adherence compared with DPP-4i users (odds ratio [OR]:1.72, 98% confidence interval [CI]:1.51, 1.96), and 2.8 times more likely compared with SU users (OR: 0.35, 98% CI: 0.07, 0.29). The discontinuation hazard ratios were 1.43 (98%CI: 1.26; 1.62) and 1.60 (98%CI: 1.42; 1.81) times higher among SGLT-2i and SU users than DPP-4i users during the follow-up period. No differences were observed for adverse events among the treatment groups. In conclusion, in our real-world setting, the combination of SGLT-2i with metformin was associated with better adherence. The mean time until discontinuation was longer in the SGLT-2i group in comparison with the DPP-4i or SU groups.

Funding

AstraZeneca, Spain [grant number ESR-16-12628]

History

Citation

Front. Endocrinol. 12:708372. doi: 10.3389/fendo.2021.708372

Author affiliation

Diabetes Research Centre, College of Life Sciences

Version

VoR (Version of Record)

Published in

FRONTIERS IN ENDOCRINOLOGY

Volume

12

Pagination

(8)

Publisher

FRONTIERS MEDIA SA

issn

1664-2392

eissn

1664-2392

Acceptance date

29/06/2021

Copyright date

2021

Available date

03/09/2021

Language

English