Laires Pedro, Kurtyka Karen, Witt Edward A, Qiu Ying, Yu Shengsheng, Iglay Kristy
a Merck & Co., Inc ., Kenilworth , NJ , USA.
b Kantar Health , Princeton , NJ , USA.
Expert Rev Pharmacoecon Outcomes Res. 2019 Feb;19(1):71-79. doi: 10.1080/14737167.2018.1510774. Epub 2018 Sep 26.
Sulfonylureas (SUs) can help manage type 2 diabetes mellitus, but often have side effects. The objective of this study was to identify factors impacting physicians' decisions to discontinue (DC) or down-titrate (DT) SU therapy.
1,026 physicians from the All Global panel were asked to rate level of concern regarding potential reasons for DC or DT on a 7-point Likert scale (1 = not concerned, 7 = extremely concerned). Physicians also provided information regarding treatment decisions from one DC patient, one DT patient, and two current SU users.
When asked to report what factors might lead them to DC or DT an SU, physicians reported that hypoglycemic events requiring medical assistance (DC = 6.0, DT = 5.9), hypoglycemic events requiring nonmedical assistance (DC = 5.9, DT = 5.9), other hypoglycemic events not requiring assistance (DT = 5.7), and treatment goals not being met (DC = 5.6) were most concerning. DC and DT patients were more likely to have experienced ≥ 1 hypoglycemic events in the previous year vs. current users (DC = 41.0%, DT = 43.1%, current = 8.8%; p < .05).
Results highlight the strong influence of hypoglycemia on physicians' decisions to DC or DT SU therapy.
磺脲类药物（SUs）有助于控制2型糖尿病，但常有副作用。本研究的目的是确定影响医生决定停用（DC）或降低剂量（DT）SU治疗的因素。
对全球所有专家小组的1026名医生进行调查，要求他们根据7分李克特量表（1 = 不担心，7 = 极其担心）对DC或DT的潜在原因的关注程度进行评分。医生们还提供了一名DC患者、一名DT患者以及两名正在使用SU的患者的治疗决策信息。
当被问及哪些因素可能导致他们对SU进行DC或DT时，医生们表示，需要医疗救助的低血糖事件（DC = 6.0，DT = 5.9）、需要非医疗救助的低血糖事件（DC = 5.9，DT = 5.9）、其他无需救助的低血糖事件（DT = 5.7）以及未达到治疗目标（DC = 5.6）最令人担忧。与当前使用者相比，DC和DT患者在前一年发生≥1次低血糖事件的可能性更高（DC = 41.0%，DT = 43.1%，当前使用者 = 8.8%；p < 0.05）。
结果突出了低血糖对医生决定DC或DT SU治疗的强烈影响。
