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Comparison of adherence and persistence among adults with type 2 diabetes mellitus initiating saxagliptin or linagliptin

View Article: PubMed Central - PubMed

ABSTRACT

Background: Adherence and persistence to antidiabetes medications are important to control blood glucose levels among individuals with type 2 diabetes mellitus (T2D).

Objectives: The objective of this study was to compare adherence and persistence over a 12-month period between patients initiating saxagliptin and patients initiating linagliptin, two dipeptidyl peptidase-4 inhibitors.

Methods: This retrospective cohort study was conducted in MarketScan® Commercial and Medicare Supplemental claims databases. Patients with T2D initiating saxagliptin or linagliptin between January 1, 2009, and June 30, 2013, were selected. Patients were required to be at least 18 years old and have 12 months of continuous enrollment prior to and following initiation. Adherence and persistence to initiated medication were measured over the 12 months after initiation using outpatient pharmacy claims. Patients were considered adherent if the proportion of days covered was ≥0.80. Patients were considered nonpersistent (or to have discontinued) if there was a gap of >60 days without initiated medication on hand. Multivariable logistic regression and multivariable Cox proportional hazard models were fit to compare adherence and persistence, respectively, between the two cohorts.

Results: There were 21,599 saxagliptin initiators (mean age 55 years; 53% male) and 5,786 linagliptin initiators (mean age 57 years; 54% male) included in the study sample. Over the 12-month follow-up, 46% of saxagliptin initiators and 42% of linagliptin initiators were considered adherent and 47% of saxagliptin initiators and 51% of linagliptin initiators discontinued their initiated medication. After controlling for patient characteristics, saxagliptin initiation was associated with significantly greater odds of being adherent (adjusted odds ratio =1.212, 95% CI 1.140–1.289) and significantly lower hazards of discontinuation (adjusted hazard ratio =0.887, 95% CI 0.850–0.926) compared with linagliptin initiation.

Conclusion: Compared with patients with T2D who initiated linagliptin, patients with T2D who initiated saxagliptin had significantly better adherence and persistence.

No MeSH data available.


Related in: MedlinePlus

AOR for being adherent (PDC ≥0.80) among patients with type 2 diabetes mellitus initiating saxagliptin or linagliptin.Abbreviations: AOR, adjusted odds ratio; PDC, proportion of days covered.
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f1-ppa-10-1471: AOR for being adherent (PDC ≥0.80) among patients with type 2 diabetes mellitus initiating saxagliptin or linagliptin.Abbreviations: AOR, adjusted odds ratio; PDC, proportion of days covered.

Mentions: After controlling for the covariates listed in the “Statistical analyses” section, saxagliptin initiators had 21% greater odds of being adherent than linagliptin initiators (adjusted odds ratio =1.212, 95% CI 1.140, 1.289) (Figure 1). Over 12 months, saxagliptin initiators had 11% lower hazards of discontinuation than linagliptin initiators (adjusted hazards ratio =0.887, 95% CI 0.850, 0.926) (Figure 2A). Both findings were statistically significant and were similar when limited to patients initiating monotherapy (Figure 2B), or patients who did not fill their index prescription via mail-order pharmacy (Figure 2C). Findings over the 24-month follow-up period for the subset of patients with sufficient enrollment following the index date were of the same direction and magnitude (Figure 2D).


Comparison of adherence and persistence among adults with type 2 diabetes mellitus initiating saxagliptin or linagliptin
AOR for being adherent (PDC ≥0.80) among patients with type 2 diabetes mellitus initiating saxagliptin or linagliptin.Abbreviations: AOR, adjusted odds ratio; PDC, proportion of days covered.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4979597&req=5

f1-ppa-10-1471: AOR for being adherent (PDC ≥0.80) among patients with type 2 diabetes mellitus initiating saxagliptin or linagliptin.Abbreviations: AOR, adjusted odds ratio; PDC, proportion of days covered.
Mentions: After controlling for the covariates listed in the “Statistical analyses” section, saxagliptin initiators had 21% greater odds of being adherent than linagliptin initiators (adjusted odds ratio =1.212, 95% CI 1.140, 1.289) (Figure 1). Over 12 months, saxagliptin initiators had 11% lower hazards of discontinuation than linagliptin initiators (adjusted hazards ratio =0.887, 95% CI 0.850, 0.926) (Figure 2A). Both findings were statistically significant and were similar when limited to patients initiating monotherapy (Figure 2B), or patients who did not fill their index prescription via mail-order pharmacy (Figure 2C). Findings over the 24-month follow-up period for the subset of patients with sufficient enrollment following the index date were of the same direction and magnitude (Figure 2D).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Adherence and persistence to antidiabetes medications are important to control blood glucose levels among individuals with type 2 diabetes mellitus (T2D).

Objectives: The objective of this study was to compare adherence and persistence over a 12-month period between patients initiating saxagliptin and patients initiating linagliptin, two dipeptidyl peptidase-4 inhibitors.

Methods: This retrospective cohort study was conducted in MarketScan® Commercial and Medicare Supplemental claims databases. Patients with T2D initiating saxagliptin or linagliptin between January 1, 2009, and June 30, 2013, were selected. Patients were required to be at least 18 years old and have 12 months of continuous enrollment prior to and following initiation. Adherence and persistence to initiated medication were measured over the 12 months after initiation using outpatient pharmacy claims. Patients were considered adherent if the proportion of days covered was ≥0.80. Patients were considered nonpersistent (or to have discontinued) if there was a gap of >60 days without initiated medication on hand. Multivariable logistic regression and multivariable Cox proportional hazard models were fit to compare adherence and persistence, respectively, between the two cohorts.

Results: There were 21,599 saxagliptin initiators (mean age 55 years; 53% male) and 5,786 linagliptin initiators (mean age 57 years; 54% male) included in the study sample. Over the 12-month follow-up, 46% of saxagliptin initiators and 42% of linagliptin initiators were considered adherent and 47% of saxagliptin initiators and 51% of linagliptin initiators discontinued their initiated medication. After controlling for patient characteristics, saxagliptin initiation was associated with significantly greater odds of being adherent (adjusted odds ratio =1.212, 95% CI 1.140–1.289) and significantly lower hazards of discontinuation (adjusted hazard ratio =0.887, 95% CI 0.850–0.926) compared with linagliptin initiation.

Conclusion: Compared with patients with T2D who initiated linagliptin, patients with T2D who initiated saxagliptin had significantly better adherence and persistence.

No MeSH data available.


Related in: MedlinePlus