Primary Care Department, Touro University California College of Osteopathic Medicine, Vallejo, CA, USA.
Novo Nordisk Pharma Ltd., Plainsboro, NJ, USA.
Adv Ther. 2022 Sep;39(9):4114-4130. doi: 10.1007/s12325-022-02181-7. Epub 2022 Jul 7.
Type 2 diabetes mellitus (T2DM) is a chronic condition associated with substantial clinical and economic burden. As multiple therapeutic options are available, patient preferences on treatment characteristics are key in T2DM therapeutic decision-making. This study aimed to determine the preferences of US patients with T2DM for therapies recommended for first pharmacologic intensification after metformin.
As part of a discrete choice experiment, an online survey was designed using literature review and qualitative interview findings. Eligibility was met by US patients with T2DM who were aged 18 years or older with an HbA ≥ 6.5%. Anonymized therapy profiles were created from six antidiabetic therapies including oral and injectable semaglutide, dulaglutide, empagliflozin, sitagliptin, and thiazolidinediones.
Eligible patients (n = 500) had a mean HbA of 7.4%, and a mean BMI of 32.0 kg/m, the majority of which (72.2%) were injectable-naïve. The treatment characteristic with greatest importance was mode and frequency of administration (35.5%), followed by body weight change (29.2%), cardiovascular event risk (19.1%), hypoglycemic event risk (9.9%), and HbA change (6.5%). An oral semaglutide-like profile was preferred by 91.9-70.1% of respondents depending on the comparator agent, and preference was significant in each comparison (p < 0.05); an injectable semaglutide-like profile was preferred by 89.3-55.7% of respondents in each comparison depending on the comparator agent.
Patients with T2DM in the USA are significantly more likely to prefer oral or injectable semaglutide-like profiles over those of key comparators from the glucagon-like peptide 1 receptor agonist, sodium-glucose cotransporter 2 inhibitor, dipeptidyl peptidase 4 inhibitor, and thiazolidinedione classes.
2 型糖尿病（T2DM）是一种与大量临床和经济负担相关的慢性疾病。由于有多种治疗选择，患者对治疗特征的偏好是 T2DM 治疗决策的关键。本研究旨在确定美国 T2DM 患者对二甲双胍后首次药物强化治疗推荐的治疗方案的偏好。
作为离散选择实验的一部分，使用文献回顾和定性访谈结果设计了在线调查。符合条件的患者为年龄在 18 岁或以上、糖化血红蛋白（HbA）≥6.5%的美国 T2DM 患者。从六种抗糖尿病药物中创建了匿名治疗方案，包括口服和注射用司美格鲁肽、度拉糖肽、恩格列净、西格列汀和噻唑烷二酮。
符合条件的患者（n=500）的平均 HbA 为 7.4%，平均体重指数（BMI）为 32.0kg/m，其中大多数（72.2%）为首次注射。最重要的治疗特征是给药方式和频率（35.5%），其次是体重变化（29.2%）、心血管事件风险（19.1%）、低血糖事件风险（9.9%）和 HbA 变化（6.5%）。根据比较药物，91.9%-70.1%的受访者更喜欢口服司美格鲁肽样方案，且在每种比较中差异均有统计学意义（p<0.05）；根据比较药物，89.3%-55.7%的受访者更喜欢注射用司美格鲁肽样方案。
美国 T2DM 患者更倾向于选择口服或注射用司美格鲁肽样方案，而不是 GLP-1 受体激动剂、SGLT2 抑制剂、DPP-4 抑制剂和噻唑烷二酮类药物的关键对照药物。
