Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Copenhagen Centre for Regulatory Science (CORS), Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
Diabetes Res Clin Pract. 2019 Dec;158:107909. doi: 10.1016/j.diabres.2019.107909. Epub 2019 Nov 4.
To characterise the patterns of switching, adherence, and persistence among adults aged ≥18 years with diabetes prescribed dipeptidyl peptidase-4 inhibitors (DPP-4is) in Australia.
The analysis included 15,915 adults newly prescribed DPP-4is (sitagliptin = 9576; vildagliptin = 1130; saxagliptin = 1126; linagliptin = 3560; and alogliptin = 523). Multivariable logistic regression model was used to compare the non-adherence (proportion of days covered [PDC] <0.80) rates whereas Cox proportional hazards regression models were used to compare switching and non-persistence (≥90-day gap) among different DPP4-is over 12-months.
Overall, 36.0% (5722/15,915) of DPP-4i users were non-adherent and 30.0% (4775/15,915) were non-persistent at 12-months. Compared to sitagliptin, vildagliptin, linagliptin, and alogliptin were not associated with higher non-adherence and non-persistence. However, saxagliptin was associated with a higher likelihood of being non-adherent (odds ratio 1.41, 95% confidence interval [CI] 1.23-1.60) or non-persistent (hazard ratio 1.27, 95% CI 1.15-1.42) compared to sitagliptin. Just 3.2% of people switched between different DPP-4is. Compared to sitagliptin, people initiated on vildagliptin, saxagliptin, alogliptin, and linagliptin were more likely to switch.
We found no significant differences in the adherence and persistence rates between alogliptin, vildagliptin or linagliptin and sitagliptin. However, saxagliptin was associated with higher non-adherence and non-persistence compared to sitagliptin. Switching was lowest amongst users of sitagliptin.
描述澳大利亚≥18 岁糖尿病患者使用二肽基肽酶-4 抑制剂（DPP-4i）的转换、依从性和持续性模式。
分析包括 15915 名新处方 DPP-4i（西格列汀=9576；维格列汀=1130；沙格列汀=1126；利格列汀=3560；阿格列汀=523）的成年人。多变量逻辑回归模型用于比较不依从率（覆盖天数比例[PDC]＜0.80），而 Cox 比例风险回归模型用于比较 12 个月内不同 DPP4-i 之间的转换和非持久性（≥90 天差距）。
总体而言，36.0%（5722/15915）的 DPP-4i 使用者不依从，30.0%（4775/15915）在 12 个月时不持久。与西格列汀相比，维格列汀、利格列汀和阿格列汀与更高的不依从性和不持久性无关。然而，与西格列汀相比，沙格列汀与更高的不依从（比值比 1.41，95%置信区间[CI] 1.23-1.60）或不持久（风险比 1.27，95%CI 1.15-1.42）的可能性相关。只有 3.2%的人在不同的 DPP-4i 之间转换。与西格列汀相比，起始使用维格列汀、沙格列汀、阿格列汀和利格列汀的人更有可能转换。
我们没有发现阿格列汀、维格列汀或利格列汀与西格列汀的依从性和持久性率有显著差异。然而，与西格列汀相比，沙格列汀与更高的不依从性和不持久性相关。与西格列汀相比，使用西格列汀的患者转换率最低。
