| アブストラクト | AIMS: To assess post-initiation predictors of discontinuation of sodium-glucose cotransporter-2 (SGLT2) inhibitors compared to dipeptidyl-peptidase-4 (DPP-4) inhibitors in the United Kingdom. MATERIALS AND METHODS: We conducted a comparative population-based retrospective cohort study using primary care data from the UK Clinical Practice Research Datalink (CPRD) with linked data to hospital and death records. We included new metformin users who initiated either SGLT2 inhibitors or DPP-4 inhibitors between January 2013 and October 2019. The main outcome was treatment discontinuation, defined as the first 90-day gap after the estimated treatment end date. We used a series of extended Cox models to assess which time-dependent predictors were associated with treatment discontinuation. To test if the hazard ratio of discontinuation for each predictor was statistically different between SGLT2 and DPP-4 inhibitors, an exposure-predictor interaction term was added to each model. RESULTS: There were 2550 new users of SGLT2 inhibitors and 8195 new users of DPP-4 inhibitors. Approximately 69% of SGLT2 inhibitor and 74% of DPP-4 inhibitor users had discontinued treatment by the end of follow-up. Occurrence of fractures after treatment initiation was a significant predictor of discontinuation of SGLT2 inhibitors (hazard ratio [HR] 4.13, 95% confidence interval [CI] 2.12-8.06) but not DPP-4 inhibitors (HR 0.93, 95% CI 0.79-1.11). The rate of treatment discontinuation was significantly higher for those with low estimated glomerular filtration rate and minimal contact with the healthcare system. Efficacy endpoints, such as heart failure and glycated haemoglobin level, were not associated with treatment discontinuation. CONCLUSIONS: Our findings reflect some discrepancy between the available evidence and prescribing behaviour for SGLT2 inhibitors. |
|---|
| ジャーナル名 | Diabetes, obesity & metabolism |
|---|
| Pubmed追加日 | 2023/8/11 |
|---|
| 投稿者 | Alkabbani, Wajd; Shah, Baiju R; Zongo, Arsene; Eurich, Dean T; Alsabbagh, Mhd Wasem; Gamble, John-Michael |
|---|
| 組織名 | School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada.;Department of Medicine, University of Toronto, Toronto, Ontario, Canada.;Division of Endocrinology, Sunnybrook Health Sciences Centre, Toronto, Ontario,;Canada.;Faculty of Pharmacy and CHU de Quebec Research Center-Universite Laval, Quebec;City, Quebec, Canada.;School of Public Health, University of Alberta, Edmonton, Alberta, Canada. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37563767/ |
|---|
