Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, F-33000 Bordeaux, France; CHU de Bordeaux, Pôle de santé publique, Service de pharmacologie médicale, F-33000 Bordeaux, France.
Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, F-33000 Bordeaux, France.
Diabetes Res Clin Pract. 2018 May;139:323-330. doi: 10.1016/j.diabres.2018.03.011. Epub 2018 Mar 9.
The purpose of this study was to determine the effects of cancer occurrence on persistence of oral antidiabetic drugs (OAD) in France.
A retrospective cohort including incident OAD users between 2006 and 2011 was set up using a permanent sample of health insurance beneficiaries (Echantillon Généraliste de Bénéficiaires, EGB). A Cox model was used to assess the association between cancer occurrence and OAD persistence. Non-persistence was defined as a gap in OAD treatment coverage between the end of a given prescription and a new one greater than or equal to 90 days. Cancer occurrence was studied as a time-dependent variable.
The study included 13,943 OAD users. Median follow-up was 760 days. After adjustment for age, sex, first OAD used, type of prescriber and polypharmacy, non-persistence risk was higher after a diagnosis of cancer: (HR: 1.93 and IC 95% 1.69; 2.21). Subgroup analyses according to cancer localization found a higher risk of non-persistence for lung cancer (HR: 2.66 and IC 95% 1.68; 4.23) and colorectal cancer (HR: 2.02 and IC 95% 1.40; 2.91).
Our findings indicate there is an association between cancer diagnosis and OAD non-persistence. Additional studies of this type would be useful to evaluate the association between cancer diagnosis and persistence of treatment of other chronic diseases.
本研究旨在确定癌症发生对法国口服降糖药（OAD）持续使用的影响。
利用医疗保险受益人的永久样本（Echantillon Généraliste de Bénéficiaires，EGB），建立了一个包含 2006 年至 2011 年间新使用 OAD 的患者的回顾性队列。使用 Cox 模型评估癌症发生与 OAD 持续使用之间的关联。非持续性定义为在给定处方结束和新处方开始之间的 OAD 治疗覆盖差距大于或等于 90 天。癌症发生被视为一个时变变量进行研究。
本研究纳入了 13943 名 OAD 用户。中位随访时间为 760 天。在调整年龄、性别、首次使用的 OAD、开处方医生类型和多药治疗后，诊断出癌症后非持续性风险更高：（HR：1.93，95%CI 1.69；2.21）。根据癌症定位的亚组分析发现，肺癌（HR：2.66，95%CI 1.68；4.23）和结直肠癌（HR：2.02，95%CI 1.40；2.91）的非持续性风险更高。
我们的研究结果表明，癌症诊断与 OAD 非持续性之间存在关联。这种类型的进一步研究将有助于评估癌症诊断与其他慢性疾病治疗持续性之间的关联。
