Mody Reema, Meyers Juliana, Yu Maria, Davis Keith, Levine Joshua A
Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA.
RTI Health Solutions, Research Triangle Park, NC, USA.
Curr Med Res Opin. 2022 Nov;38(11):1785-1795. doi: 10.1080/03007995.2022.2085962. Epub 2022 Jun 27.
To report on the use of antihyperglycemic agents (AHAs) by age (i.e. <65, ≥65 years) in patients with type 2 diabetes (T2D) and cardiovascular disease (CVD) or cardiovascular risk (CV risk) factors in the United States.
Patients with T2D and CVD (CVD cohort) or T2D and an additional CV risk factor without pre-existing CVD (CV risk cohort) were identified from 2015 to 2019 in a claims database. Patients were followed from their first observed CVD diagnosis or CV risk factor for each year they were continuously enrolled or until occurrence of a CVD diagnosis (CV risk cohort only). Classes of AHAs received were reported by year, cohort, and age group.
From 2015 to 2019, the percentage of patients <65 years on glucagon-like peptide-1 receptor agonists (GLP-1 RAs) increased (CVD: 9-17%, CV risk: 9-17%) and was approximately twice that of those ≥65 years (CVD: 4-8%, CV risk: 4-8%); the percentage of patients <65 years on sodium-glucose cotransporter-2 (SGLT2) inhibitors increased (CVD: 11-16%, CV risk: 11-17%) and was approximately triple that of those ≥65 years (CVD: 3-6%, CV risk: 4-7%).
The use of GLP-1 RAs and SGLT2 inhibitors increased during the study period; however, most patients did not receive these medications. Patients aged ≥65 years were particularly disadvantaged.
报告美国2型糖尿病（T2D）合并心血管疾病（CVD）或心血管风险（CV风险）因素患者按年龄（即<65岁、≥65岁）使用抗高血糖药物（AHA）的情况。
2015年至2019年期间，在一个理赔数据库中识别出患有T2D和CVD的患者（CVD队列）或患有T2D且有额外CV风险因素但无既往CVD的患者（CV风险队列）。从首次观察到的CVD诊断或CV风险因素开始，对患者进行随访，随访时间为他们连续入组的每一年，或直至出现CVD诊断（仅CV风险队列）。按年份、队列和年龄组报告接受的AHA类别。
2015年至2019年期间，年龄<65岁使用胰高血糖素样肽-1受体激动剂（GLP-1 RA）的患者百分比增加（CVD：9%-17%，CV风险：9%-17%），约为年龄≥65岁患者的两倍（CVD：4%-8%，CV风险：4%-8%）；年龄<65岁使用钠-葡萄糖协同转运蛋白-2（SGLT2）抑制剂的患者百分比增加（CVD：11%-16%，CV风险：11%-17%），约为年龄≥65岁患者的三倍（CVD：3%-6%，CV风险：4%-7%）。
在研究期间，GLP-1 RA和SGLT2抑制剂的使用有所增加；然而，大多数患者未接受这些药物治疗。65岁及以上的患者尤其处于劣势。
