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.
Diabetes Metab Res Rev. 2021 Jan;37(1):e3350. doi: 10.1002/dmrr.3350. Epub 2020 Jun 23.
Despite increasing prescription of sodium glucose co-transporter 2 (SGLT2) inhibitors, there is limited insight of the patterns of use among patients with diabetes prescribed these drugs. This study aimed to summarize available real-world data on the adherence and persistence to SGLT2 inhibitors.
A systematic review for observational studies reporting the adherence and persistence to SGLT2 inhibitors was performed in Medline, Embase, and Web of Science from their inception to October 2019. Data were analysed via random-effects meta-analysis.
A total of 22 studies (31 cohorts) comprising 123 854 individuals prescribed SGLT2 inhibitors from eight countries were included. The pooled mean proportions of days covered [PDC] at six months and one year were 0.77 (95% confidence interval [CI] 0.72-0.82) and 0.72 (95% CI 0.66-0.77), respectively. The pooled proportions adherent (PDC ≥0.80) at six months and one year were 59.5% (95% CI 52.9-65.9) and 49.0% (95% CI 42.3-55.8), respectively. The pooled proportions of people persistent at six months, one year, and two years were 80.1% (95% CI 75.8-84.0), 61.8% (95% CI 57.8-65.7), and 45.9% (95% CI 35.5-56.5), respectively. When persistence was defined as the absence of ≥90-days gap, the equivalent pooled proportions persistent were 81.5% (95% CI 73.1-88.6), 58.9% (95% CI 53.1-64.6), and 34.7% (95% CI 33.6-35.8). Adherence and persistence appeared to vary across different SGLT2 inhibitors.
Real-world adherence and persistence to SGLT2 inhibitors is poor. Hence, targets for improving treatment adherence and persistence need to be identified and appropriate interventions implemented.
尽管钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂的处方量不断增加，但对于接受此类药物治疗的糖尿病患者的用药模式，我们的了解仍很有限。本研究旨在总结目前关于 SGLT2 抑制剂的使用依从性和持久性的真实世界数据。
通过对 Medline、Embase 和 Web of Science 数据库进行系统性回顾，检索截至 2019 年 10 月报告 SGLT2 抑制剂使用依从性和持久性的观察性研究，分析数据时采用随机效应荟萃分析。
共纳入来自 8 个国家的 22 项研究（31 个队列），共 123854 例患者接受 SGLT2 抑制剂治疗。6 个月和 1 年时的平均（95%置信区间）药物覆盖天数（PDC）分别为 0.77（0.72-0.82）和 0.72（0.66-0.77）。6 个月和 1 年时的 PDC 依从性（PDC≥0.80）比例分别为 59.5%（95%置信区间 52.9-65.9）和 49.0%（95%置信区间 42.3-55.8）。6 个月、1 年和 2 年时的持续治疗比例分别为 80.1%（95%置信区间 75.8-84.0）、61.8%（95%置信区间 57.8-65.7）和 45.9%（95%置信区间 35.5-56.5）。当持续治疗定义为无≥90 天停药间隔时，对应的持续治疗比例分别为 81.5%（95%置信区间 73.1-88.6）、58.9%（95%置信区间 53.1-64.6）和 34.7%（95%置信区间 33.6-35.8）。不同的 SGLT2 抑制剂的依从性和持久性似乎存在差异。
真实世界中 SGLT2 抑制剂的使用依从性和持久性较差。因此，需要确定提高治疗依从性和持久性的目标，并实施适当的干预措施。
