Glucose-lowering treatment pathways of individuals with chronic kidney disease and type 2 diabetes according to the Kidney Disease: Improving Global Outcomes 2012 risk classification.

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Glucose-lowering treatment pathways of individuals with chronic kidney disease and type 2 diabetes according to the Kidney Disease: Improving Global Outcomes 2012 risk classification.

Glucose-lowering treatment pathways of individuals with chronic kidney disease and type 2 diabetes according to the Kidney Disease: Improving Global Outcomes 2012 risk classification.

アブストラクト	AIMS: To describe treatment pathways for key glucose-lowering therapies in individuals with chronic kidney disease (CKD) and type 2 diabetes (T2D) using retrospective data from DISCOVER CKD (NCT04034992). METHODS: Data were extracted from the UK Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics data (2008-2020) and the US integrated Limited Claims and Electronic Health Records Database (LCED; 2012-2019). Eligible individuals were aged >/=18 years with CKD, identified by two consecutive estimated glomerular filtration rate (eGFR) measures (15-<75 mL/min/1.73 m(2) ; 90-730 days apart; index date was the second measurement) and T2D. Chronological treatment pathways for glucose-lowering therapies prescribed on or after CKD index to end of follow-up were computed. Median time and proportion of overall follow-up time on treatment were described for each therapy by database and by eGFR and urinary albumin-to-creatinine ratio (UACR) categories. RESULTS: Of 36,951 and 4339 eligible individuals in the CPRD and LCED, respectively, median baseline eGFR was 67.8 and 64.9 mL/min/1.73 m(2) ; 64.2 and 63.9% received metformin prior to index; and median (interquartile range) time on metformin during follow-up was 917 (390-1671) and 454 (192-850) days (accounting for ~75% of follow-up time in both databases). The frequency of combination treatment increased over time. There were trends towards decreased metformin prescriptions with decreasing eGFR and increasing UACR within each eGFR category. CONCLUSIONS: Individuals with CKD and T2D had many combinations of therapies and substantial follow-up time on therapy. These results highlight opportunities for improved CKD management.
ジャーナル名	Diabetic medicine : a journal of the British Diabetic Association
Pubmed追加日	2023/8/14
投稿者	Pollock, Carol; Sanchez, Juan Jose Garcia; Carrero, Juan-Jesus; Kumar, Supriya; Pecoits-Filho, Roberto; Lam, Carolyn S P; Chen, Hungta; Kanda, Eiichiro; Lainscak, Mitja; Wheeler, David C
組織名	Royal North Shore Hospital, Kolling Institute, University of Sydney, St Leonards,;New South Wales, Australia.;Global Market Access and Pricing, BioPharmaceuticals Medical, AstraZeneca,;Cambridge, UK.;Department of Medical Epidemiology and Biostatistics, Karolinska Institutet,;Stockholm, Sweden.;Real World Data Science, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg,;Maryland, USA.;School of Medicine, Pontifical Catholic University of Parana, Curitiba, Brazil.;Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA.;Department of Cardiology, National Heart Centre Singapore, Singapore City,;Singapore.;Duke-NUS Medical School, Singapore City, Singapore.;Medical and Payer Evidence Statistics, BioPharmaceuticals Medical, AstraZeneca,;Gaithersburg, Maryland, USA.;Kawasaki Medical School, Kurashiki, Japan.;Division of Cardiology, General Hospital Murska Sobota, and Faculty of Medicine,;University of Ljubljana, Ljubljana, Slovenia.;Department of Renal Medicine, University College London, London, UK.
Pubmed リンク	https://www.ncbi.nlm.nih.gov/pubmed/37578188/