Analysis of the Adherence and Safety of Second Oral Glucose-Lowering Therapy in Routine Practice From the Mediterranean Area : A Retrospective Cohort Study
Vlacho, Bogdan (Institut d'Investigació Biomèdica Sant Pau)
Mata-Cases, M. (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Mundet-Tudurí, Xavier (Universitat Autònoma de Barcelona. Departament de Medicina)
Vallès-Callol, J.A. (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Real, J. (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Farre, Magi (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cos Claramunt, Francesc Xavier (Institut Català de la Salut)
Khunti, K. (Diabetes Research Centre. College of Life Sciences. University of Leicester)
Mauricio Puente, Dídac (Institut d'Investigació Biomèdica Sant Pau)
Franch-Nadal, J. (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)

Fecha:	2021
Resumen:	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.
Nota:	Altres ajuts: AstraZeneca/ESR-16-12628 ; Applied Research Collaboration East Midlands (ARC EM) ; National Institute for Health Research (NIHR) ; Imperial Biomedical Research Centre (NIHR)
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Adherence compliance persistence ; Glycemia control ; Type 2 diabetes ; Primary care ; Observational study
Publicado en:	Frontiers in endocrinology, Vol. 12 (July 2021) , p. 708372, ISSN 1664-2392

DOI: 10.3389/fendo.2021.708372
PMID: 34335477

8 p, 1.1 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut de Recerca Sant Pau
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