Identification of subgroups of patients with type 2 diabetes with differences in renal function preservation between sglt2 inhibitors and dpp4 inhibitors using a supervised machine learning algorithm (profile study): A Retrospective analysis of a japanese commercial medical database.
AIMS: We investigated the effects of SGLT2 inhibitors vs DPP4 inhibitors on renal function preservation using real-world data of patients with type 2 diabetes in Japan, and identified which subgroups of patients showed greater benefits on renal function preservation with SGLT2 inhibitors vs DPP4 inhibitors.
METHODS: We retrospectively analysed claims data recorded in the Medical Data Vision database in Japan of patients with type 2 diabetes (aged >/=18 years) prescribed any SGLT2 inhibitor or any DPP4 inhibitor between May 2014 and September 2016 (identification period), in whom estimated glomerular filtration rate (eGFR) was measured at least twice (baseline, up to 6 months before the index date; follow-up: 9-15 months after the index date) with continuous treatment until the follow-up eGFR. The endpoint was the percent of patients with renal function preservation (RFP), defined as no change or an increase in eGFR from baseline to follow-up. A proprietary supervised learning algorithm (Q-Finder(R)) was used to identify the profiles of patients with an additional RFP benefit of SGLT2 inhibitors vs DPP4 inhibitors.
RESULTS: Data were available for 990 patients prescribed SGLT2 inhibitors and 4,257 prescribed DPP4 inhibitors. The proportion of patients with RFP was significantly greater in the SGLT2 inhibitor group (OR=1.27, P=0.01). The Q-finder(R) algorithm identified four clinically relevant subgroups showing superior RFP with SGLT2 inhibitors (P<0.1): no hyperlipidaemia and eGFR >/=79 mL/min/1.73 m(2) ; eGFR >/=79 mL/min/1.73 m(2) and diabetes duration </=1.2 years; eGFR >/=75 mL/min/1.73 m(2) and use of antithrombotic agents; and haemoglobin </=13.4 g/dL and low-density lipoprotein-C >/=95.1 mg/dL. In each profile, glycaemic control was comparable in both groups.
CONCLUSION: SGLT2 inhibitors were associated with more favourable renal functional preservation vs DPP4 inhibitors in patients with certain profiles in real-world settings in Japan. This article is protected by copyright. All rights reserved.
|ジャーナル名||Diabetes, obesity & metabolism|
|投稿者||Zhou, Fang Liz; Watada, Hirotaka; Tajima, Yuki; Berthelot, Mathilde; Kang, Dian; Esnault, Cyril; Shuto, Yujin; Maegawa, Hiroshi; Koya, Daisuke|
|組織名||Sanofi, Bridgewater, NJ, USA.;Juntendo University Graduate School of Medicine, Tokyo, Japan.;Sanofi K.K., Tokyo, Japan.;Quinten, Paris, France.;Shiga University of Medical Science, Otsu, Japan.;Kanazawa Medical University, Uchinada, Japan.|