Iglay Kristy, Sawhney Baanie, Fu Alex Z, Fernandes Gail, Crutchlow Michael F, Rajpathak Swapnil, Khunti Kamlesh
Merck & Co., Inc. Kenilworth NJ USA.
Complete HEOR Solutions (CHEORS) North Wales PA USA.
Endocrinol Diabetes Metab. 2019 Dec 17;3(1):e00107. doi: 10.1002/edm2.107. eCollection 2020 Jan.
To assess the dose distribution among users of metformin monotherapy as well as the patterns of up-titration following initiation of therapy in people with type 2 diabetes mellitus (T2DM).
This was a retrospective cohort study of adults with T2DM in the United Kingdom (UK). Metformin dose distribution was assessed at 0, 6 and 12 months in people initiating metformin monotherapy (new users) and cross-sectionally in people with ongoing metformin monotherapy (prevalent users). Patterns and predictors of up-titration were also analysed in new users. Dose distributions and treatment patterns were assessed descriptively; predictors of up-titration were determined using multivariable logistic regressions.
Totals of 6174 new users and 8733 prevalent users were included. New users initiated metformin at >0 mg to ≤500 mg (25%), >500 mg to ≤1000 mg (47%), >1000 mg to ≤1500 mg (17%) or >1500 mg to ≤2000 mg (12%) daily. This distribution did not vary over time. Prevalent users of metformin received doses of >0 mg to ≤500 mg (14%), >500 mg to ≤1000 mg (40%), >1000 mg to ≤1500 mg (15%), >1500 mg to ≤2000 mg (29%) or >2000 mg (1%) daily. Among new users of metformin, 6.7% and 10.8% had been up-titrated at 6 and 12 months, respectively, despite the majority having glycated haemoglobin >53 mmol/mol. Predictors of up-titration included younger age and higher HbA1c.
A majority of T2DM patients taking metformin received a dose ≤1000 mg/day. Up-titration of metformin is infrequent in the first year postinitiation.
评估2型糖尿病（T2DM）患者中二甲双胍单药治疗使用者的剂量分布情况以及治疗起始后剂量递增模式。
这是一项针对英国成年T2DM患者的回顾性队列研究。对开始二甲双胍单药治疗的患者（新使用者）在0、6和12个月时评估二甲双胍剂量分布情况，并对正在接受二甲双胍单药治疗的患者（现患使用者）进行横断面评估。还分析了新使用者剂量递增的模式和预测因素。对剂量分布和治疗模式进行描述性评估；使用多变量逻辑回归确定剂量递增的预测因素。
共纳入6174名新使用者和8733名现患使用者。新使用者起始二甲双胍的剂量为每日>0mg至≤500mg（25%）、>500mg至≤1000mg（47%）、>1000mg至≤1500mg（17%）或>1500mg至≤2000mg（12%）。这种分布未随时间变化。二甲双胍现患使用者每日接受的剂量为>0mg至≤500mg（14%）、>500mg至≤1000mg（40%）、>1000mg至≤1500mg（15%）、>1500mg至≤2000mg（29%）或>2000mg（1%）。在二甲双胍新使用者中，尽管大多数糖化血红蛋白>53mmol/mol，但分别有6.7%和10.8%在第6和12个月时进行了剂量递增。剂量递增的预测因素包括年龄较小和糖化血红蛋白水平较高。
大多数服用二甲双胍的T2DM患者接受的剂量≤1000mg/天。起始治疗后的第一年中，二甲双胍剂量递增情况不常见。
