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开始使用钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)的糖尿病患者特征:来自日本三个行政数据库的真实世界结果

Characteristics of Patients with Diabetes Initiating Sodium Glucose Co-transporter-2 Inhibitors (SGLT2i): Real-World Results from Three Administrative Databases in Japan.

作者信息

Ito Yuichiro, Van Schyndle James, Nishimura Takuya, Sugitani Toshifumi, Kimura Tomomi

机构信息

Astellas Pharma Inc., Tokyo, Japan.

Astellas US, LLC., Northbrook, IL, USA.

出版信息

Diabetes Ther. 2019 Apr;10(2):549-562. doi: 10.1007/s13300-019-0577-7. Epub 2019 Feb 7.

DOI:10.1007/s13300-019-0577-7
PMID:30730037
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6437244/
Abstract

INTRODUCTION

The aim of this study was to evaluate the characteristics of new users of sodium glucose co-transporter-2 inhibitors (SGLT2i) in comparison with those of new users of other oral antidiabetic drugs (OADs) using data retrieved from three administrative databases in Japan.

METHODS

This study included adult patients from each database who started an OAD between 2014 and 2017. Outpatients who started SGLT2i therapy were included in the SGLT2i cohort. The remaining outpatients were grouped according to the OAD class of their earliest initial prescription after no use of the index OAD during the 6-month pre-index period. Diabetes-related complications were evaluated using the Diabetes Complication Severity Index.

RESULTS

In total, 176,355 patients in the hospital-based administrative database (H-dataset), 98,361 in the pharmacy claims database (P-dataset) and 37,786 in the insurance claims database (I-dataset) were analyzed. In the H-dataset, SGLT2i users, compared with users of other OADs, tended to be younger (mean age at index: 57.7 vs. 60.3-69.2 years) and to have a higher prevalence of hypercholesterolemia (73.5 vs. 55.2-71.4%), a higher mean body weight (74.4 vs. 60.5-70.8 kg), a higher body mass index (27.6 vs. 23.5-26.4 kg/m) and a higher glycated hemoglobin level (8.4 vs. 7.4-8.1%). There were no distinct differences in the prevalence of complications between SGLT2i users and users of other OADs in the H-dataset. Similar trends were noted in the other datasets.

CONCLUSION

Patients initiating SGLT2i therapy differed in several characteristics from new users of other OADs. SGLT2i were prescribed more frequently to younger patients, those at increased cardiovascular risk or those with poorer glycemic control.

FUNDING

Astellas Pharma Inc., Tokyo, Japan.

摘要

引言

本研究旨在利用从日本三个行政数据库检索到的数据,评估钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)新使用者与其他口服抗糖尿病药物(OAD)新使用者的特征。

方法

本研究纳入了各数据库中2014年至2017年间开始使用OAD的成年患者。开始SGLT2i治疗的门诊患者被纳入SGLT2i队列。其余门诊患者根据其在索引OAD使用前6个月未使用期间最早初始处方的OAD类别进行分组。使用糖尿病并发症严重程度指数评估糖尿病相关并发症。

结果

总共分析了基于医院的行政数据库(H数据集)中的176355例患者、药房索赔数据库(P数据集)中的98361例患者和保险索赔数据库(I数据集)中的37786例患者。在H数据集中,与其他OAD使用者相比,SGLT2i使用者往往更年轻(索引时的平均年龄:57.7岁对60.3 - 69.2岁),高胆固醇血症患病率更高(73.5%对55.2 - 71.4%),平均体重更高(74.4千克对60.5 - 70.8千克),体重指数更高(27.6对23.5 - 26.4千克/平方米),糖化血红蛋白水平更高(8.4%对7.4 - 8.1%)。在H数据集中,SGLT2i使用者与其他OAD使用者之间并发症患病率没有明显差异。在其他数据集中也观察到类似趋势。

结论

开始SGLT2i治疗的患者在几个特征上与其他OAD新使用者不同。SGLT2i在年轻患者、心血管风险增加的患者或血糖控制较差的患者中处方更频繁。

资金来源

日本东京安斯泰来制药公司。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/6437244/e60d01694917/13300_2019_577_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/6437244/9399ec8321a8/13300_2019_577_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/6437244/0850c8bb93b2/13300_2019_577_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/6437244/e60d01694917/13300_2019_577_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/6437244/9399ec8321a8/13300_2019_577_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/6437244/0850c8bb93b2/13300_2019_577_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea3/6437244/e60d01694917/13300_2019_577_Fig3_HTML.jpg

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