| アブストラクト | OBJECTIVE: To evaluate trends in antidiabetic medication initiation patterns among patients with type 2 diabetes mellitus (T2DM) with and without chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS: A retrospective cohort study using the UK Clinical Practice Research Datalink (2006-2020) was conducted to evaluate the overall, first-, and second line (after metformin) medication initiation patterns among patients with CKD (n = 38,622) and those without CKD (n = 230,963) who had T2DM. RESULTS: Relative to other glucose-lowering therapies, metformin initiations declined overall but remained the first-line treatment of choice for both patients with and those without CKD. Sodium-glucose cotransporter-2 (SGLT2i) use increased modestly among patients with CKD, but this increase was more pronounced among patients without CKD; by 2020, patients without CKD, compared with patients with CKD, were three (28.5% vs. 9.4%) and six (46.3% vs. 7.9%) times more likely to initiate SGLT2i overall and as second-line therapy, respectively. Glucagon-like peptide 1 receptor agonist (GLP-1RA) use was minimal regardless of CKD status (<5%), whereas both dipeptidyl peptidase-4 inhibitor (DPP4i) and sulfonylurea use remained high among patients with CKD. For instance, by 2020, and among patients with CKD, DPP4i and sulfonylureas constituted 28.3% and 20.6% of all initiations, and 57.4% and 30.3% of second-line initiations, respectively. CONCLUSIONS: SGLT2i use increased among patients with T2DM, but this increase was largely driven by patients without CKD. Work is needed to identify barriers associated with the uptake of therapies with proven cardiorenal benefits (e.g., SGLT2i, GLP-1RA) among patients with CKD. |
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| ジャーナル名 | Diabetes care |
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| Pubmed追加日 | 2022/8/20 |
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| 投稿者 | Liaw, Julia; Harhay, Meera; Setoguchi, Soko; Gerhard, Tobias; Dave, Chintan V |
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| 組織名 | Center for Pharmacoepidemiology and Treatment Science, Institute for Health,;Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ.;Department of Pharmacy Practice and Administration, Ernest Mario School of;Pharmacy, Rutgers University, Piscataway, NJ.;Department of Medicine, Drexel University College of Medicine, Philadelphia, PA.;Department of Epidemiology and Biostatistics, Drexel University Dornsife School;of Public Health, Philadelphia, PA.;Department of Medicine, Renal Electrolyte and Hypertension Division, University;of Pennsylvania Health System, Philadelphia, PA.;Department of Medicine, Rutgers Robert Wood Johnson Medical School, New;Brunswick, NJ.;Department of Veterans Affairs-New Jersey Health Care System, East Orange, NJ. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35984049/ |
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