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Determinants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti-diabetic drugs.

Saine ME, Carbonari DM, Newcomb CW, Nezamzadeh MS, Haynes K, Roy JA, Cardillo S, Hennessy S, Holick CN, Esposito DB, Gallagher AM, Bhullar H, Strom BL, Lo Re V - BMC Pharmacol Toxicol (2015)

Bottom Line: We compared the characteristics of T2DM patients who were new initiators of saxagliptin to those who were new initiators of non-dipeptidyl peptidase-4 (DPP-4) inhibitor oral anti-diabetic drugs (OADs) and identified factors associated with saxagliptin use.Across all four data sources, prior OAD use, hypertension, and hyperlipidemia were associated with saxagliptin use.Saxagliptin initiation was also associated with hemoglobin A1c results >8% within the UK data sources, and a greater number of hemoglobin A1c measurements in the US data sources.

View Article: PubMed Central - PubMed

Affiliation: Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA, USA. msaine@mail.med.upenn.edu.

ABSTRACT

Background: The patterns and determinants of saxagliptin use among patients with type 2 diabetes mellitus (T2DM) are unknown in real-world settings. We compared the characteristics of T2DM patients who were new initiators of saxagliptin to those who were new initiators of non-dipeptidyl peptidase-4 (DPP-4) inhibitor oral anti-diabetic drugs (OADs) and identified factors associated with saxagliptin use.

Methods: We conducted a cross-sectional study within the Clinical Practice Research Datalink (CPRD), The Health Improvement Network (THIN), US Medicare, and the HealthCore Integrated Research Database (HIRD(SM)) across the first 36 months of saxagliptin availability (29 months for US Medicare). Patients were included if they were: 1) ≥18 years old, 2) newly prescribed saxagliptin or a non-DPP-4 inhibitor OAD, and 3) enrolled in their respective database for 180 days. For each saxagliptin initiator, we randomly selected up to ten non-DPP-4 inhibitor OAD initiators matched on age, sex, and geographic region. Conditional logistic regression was used to identify determinants of saxagliptin use.

Results: We identified 64,079 saxagliptin initiators (CPRD: 1,962; THIN: 2,084; US Medicare: 51,976; HIRD(SM): 8,057) and 610,660 non-DPP-4 inhibitor OAD initiators (CPRD: 19,484; THIN: 19,936; US Medicare: 493,432; HIRD(SM): 77,808). Across all four data sources, prior OAD use, hypertension, and hyperlipidemia were associated with saxagliptin use. Saxagliptin initiation was also associated with hemoglobin A1c results >8% within the UK data sources, and a greater number of hemoglobin A1c measurements in the US data sources.

Conclusions: In these UK and US data sources, initiation of saxagliptin was associated with prior poor glycemic control, prior OAD use, and diagnoses of hypertension and hyperlipidemia.

Trial registration: ClinicalTrials.gov identifiers NCT01086280 , NCT01086293 , NCT01086319 , NCT01086306 , and NCT01377935.

No MeSH data available.


Related in: MedlinePlus

Selection of saxagliptin patients. a: Clinical Practice Research Datalink (CPRD). b: The Health Improvement Network (THIN). c: US Medicare. d: HealthCore Integrated Research DatabaseSM (HIRDSM).
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Fig1: Selection of saxagliptin patients. a: Clinical Practice Research Datalink (CPRD). b: The Health Improvement Network (THIN). c: US Medicare. d: HealthCore Integrated Research DatabaseSM (HIRDSM).

Mentions: Within THIN and CPRD, respectively, we identified, 1,962 and 2,084 new initiators of saxagliptin (Figure 1a and b) as well as 19,484 and 19,936 matched new initiators of non-DPP-4 inhibitor OADs. The characteristics of these patients are presented in Table 1. Approximately 6% of saxagliptin initiators in each UK data source had not received treatment for T2DM with another OAD within 180 days prior to the index date.Figure 1


Determinants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti-diabetic drugs.

Saine ME, Carbonari DM, Newcomb CW, Nezamzadeh MS, Haynes K, Roy JA, Cardillo S, Hennessy S, Holick CN, Esposito DB, Gallagher AM, Bhullar H, Strom BL, Lo Re V - BMC Pharmacol Toxicol (2015)

Selection of saxagliptin patients. a: Clinical Practice Research Datalink (CPRD). b: The Health Improvement Network (THIN). c: US Medicare. d: HealthCore Integrated Research DatabaseSM (HIRDSM).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4404079&req=5

Fig1: Selection of saxagliptin patients. a: Clinical Practice Research Datalink (CPRD). b: The Health Improvement Network (THIN). c: US Medicare. d: HealthCore Integrated Research DatabaseSM (HIRDSM).
Mentions: Within THIN and CPRD, respectively, we identified, 1,962 and 2,084 new initiators of saxagliptin (Figure 1a and b) as well as 19,484 and 19,936 matched new initiators of non-DPP-4 inhibitor OADs. The characteristics of these patients are presented in Table 1. Approximately 6% of saxagliptin initiators in each UK data source had not received treatment for T2DM with another OAD within 180 days prior to the index date.Figure 1

Bottom Line: We compared the characteristics of T2DM patients who were new initiators of saxagliptin to those who were new initiators of non-dipeptidyl peptidase-4 (DPP-4) inhibitor oral anti-diabetic drugs (OADs) and identified factors associated with saxagliptin use.Across all four data sources, prior OAD use, hypertension, and hyperlipidemia were associated with saxagliptin use.Saxagliptin initiation was also associated with hemoglobin A1c results >8% within the UK data sources, and a greater number of hemoglobin A1c measurements in the US data sources.

View Article: PubMed Central - PubMed

Affiliation: Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA, USA. msaine@mail.med.upenn.edu.

ABSTRACT

Background: The patterns and determinants of saxagliptin use among patients with type 2 diabetes mellitus (T2DM) are unknown in real-world settings. We compared the characteristics of T2DM patients who were new initiators of saxagliptin to those who were new initiators of non-dipeptidyl peptidase-4 (DPP-4) inhibitor oral anti-diabetic drugs (OADs) and identified factors associated with saxagliptin use.

Methods: We conducted a cross-sectional study within the Clinical Practice Research Datalink (CPRD), The Health Improvement Network (THIN), US Medicare, and the HealthCore Integrated Research Database (HIRD(SM)) across the first 36 months of saxagliptin availability (29 months for US Medicare). Patients were included if they were: 1) ≥18 years old, 2) newly prescribed saxagliptin or a non-DPP-4 inhibitor OAD, and 3) enrolled in their respective database for 180 days. For each saxagliptin initiator, we randomly selected up to ten non-DPP-4 inhibitor OAD initiators matched on age, sex, and geographic region. Conditional logistic regression was used to identify determinants of saxagliptin use.

Results: We identified 64,079 saxagliptin initiators (CPRD: 1,962; THIN: 2,084; US Medicare: 51,976; HIRD(SM): 8,057) and 610,660 non-DPP-4 inhibitor OAD initiators (CPRD: 19,484; THIN: 19,936; US Medicare: 493,432; HIRD(SM): 77,808). Across all four data sources, prior OAD use, hypertension, and hyperlipidemia were associated with saxagliptin use. Saxagliptin initiation was also associated with hemoglobin A1c results >8% within the UK data sources, and a greater number of hemoglobin A1c measurements in the US data sources.

Conclusions: In these UK and US data sources, initiation of saxagliptin was associated with prior poor glycemic control, prior OAD use, and diagnoses of hypertension and hyperlipidemia.

Trial registration: ClinicalTrials.gov identifiers NCT01086280 , NCT01086293 , NCT01086319 , NCT01086306 , and NCT01377935.

No MeSH data available.


Related in: MedlinePlus