Chen-Ku Chih H, Grimaldo de Sucre Pilar, Vinocour Mary, Ramírez-Zamora Luis C, Andrés-Jiménez Fernando, Slon-Hitti Claudio, Cob Alejandro, Rodríguez Guiselle
Endocrinology, Clinica Los Yoses, San Pedro, CRI.
Internal Medicine, Hospital Aquilino Tejeira, Penonomé, PAN.
Cureus. 2021 Jun 30;13(6):e16060. doi: 10.7759/cureus.16060. eCollection 2021 Jun.
This study aimed to describe the prescription patterns of second-line medications for patients with diabetes from selected centers in Costa Rica and Panama.
DISCOVER is a registry of patients with type 2 diabetes switching from first- to second-line medications. We analyzed medication choice and the reasons to switch for each country. Results: A total of 219 patients were included during 2014-2016, 127 in Costa Rica and 92 in Panama. The most frequently prescribed first-line medication was metformin, followed by sulphonylureas in Panama, and a combination of metformin and dipeptidyl peptidase-4 inhibitor (iDPP4) in Costa Rica. DPP4 inhibitors plus metformin was the most commonly prescribed second-line medication, followed by metformin combined with sodium-glucose transport protein-2 inhibitor (iSGLT2) in Costa Rica and iDPP4 in monotherapy in Panama. The main reason to switch being efficacy. When choosing the second-line medication, the main reasons behind the switch were efficacy, weight loss, and hypoglycemia risk in both countries (tolerability being also common in Panama).
According to the DISCOVER registry, in Costa Rica and Panama, efficacy is the most common reason to switch to second-line medication. Metformin plus iDPP4 was the most commonly prescribed agent.
本研究旨在描述来自哥斯达黎加和巴拿马选定中心的糖尿病患者二线药物的处方模式。
DISCOVER是一个2型糖尿病患者从一线药物转换为二线药物的登记系统。我们分析了每个国家的药物选择和换药原因。结果：2014年至2016年期间共纳入219例患者，其中哥斯达黎加127例，巴拿马92例。最常处方的一线药物是二甲双胍，在巴拿马其次是磺脲类药物，在哥斯达黎加是二甲双胍和二肽基肽酶-4抑制剂（DPP4i）的联合用药。DPP4抑制剂加二甲双胍是最常处方的二线药物，在哥斯达黎加其次是二甲双胍联合钠-葡萄糖转运蛋白-2抑制剂（SGLT2i），在巴拿马是DPP4i单药治疗。换药的主要原因是疗效。在选择二线药物时，两国换药背后的主要原因都是疗效、体重减轻和低血糖风险（耐受性在巴拿马也很常见）。
根据DISCOVER登记系统，在哥斯达黎加和巴拿马，疗效是转换为二线药物最常见的原因。二甲双胍加DPP4i是最常处方的药物。
