2005-2019 年美国有冠心病或心力衰竭史的 2 型糖尿病成人中新的降糖药物利用模式趋势。

Trends in utilization patterns of newer glucose-lowering drugs in US adults with type 2 diabetes and a history of coronary heart disease or heart failure: 2005-2019.

机构信息

Center for Drug Evaluation and Safety, Department of Pharmaceutical Evaluation and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA; Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia.

Center for Drug Evaluation and Safety, Department of Pharmaceutical Evaluation and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA.

出版信息

Prim Care Diabetes. 2024 Oct;18(5):561-563. doi: 10.1016/j.pcd.2024.07.003. Epub 2024 Aug 2.

DOI:10.1016/j.pcd.2024.07.003

PMID:39095227

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11616792/

Abstract

BACKGROUND

The newer glucose-lowering drugs (GLDs), including Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), have demonstrated superior cardio- and renal protective benefits compared to older GLDs in individuals with type 2 diabetes (T2D) at high risk for cardiovascular disease (CVD).

OBJECTIVE

This study examined the trends of the newer GLDs use in people with T2D who had a history of coronary heart disease or heart failure in the United States.

METHOD

We used 2005-2019 data from the Medical Expenditure Panel Survey (MEPS). Individuals with self-reported diabetes and CVD history were identified.

RESULTS

There was a steady increase in the use of GLP-1RA only from 2008 (3 %) to 2019 (21 %) and SGLT2i only from 2014 (5 %) to 2019 (12 %). Individuals with dual use of both newer GLD classes increased from 0.62 % in 2015 to 6 % in 2019. The overall uptake of these two newer drugs in 2019 was less than 40 %. In other words, 60 % of individuals who can substantially benefit from these newer treatments did not use the treatments.

CONCLUSION

The use of GLP-1RA and SGLT2i among individuals with T2D and a history of CVD was low and varied by insurance type. Policy-level interventions are needed to improve the use of these newer treatments further.

SUMMARY

We examined how newer glucose-lowering drugs are used among individuals with type 2 diabetes and at high risk for coronary heart disease or heart failure in the US. We found that 60 % of individuals who can substantially benefit from these newer treatments did not use the treatments due to the variation of insurance type.

摘要

背景

与 2 型糖尿病（T2D）患者中具有心血管疾病（CVD）高危因素相比，新型降糖药物（GLDs），包括胰高血糖素样肽-1 受体激动剂（GLP-1RA）和钠-葡萄糖协同转运蛋白 2 抑制剂（SGLT2i），在心血管和肾脏保护方面具有明显优势。

目的

本研究在美国，检查了有冠心病或心力衰竭病史的 T2D 患者中新型 GLD 使用的趋势。

方法

我们使用了 2005-2019 年来自医疗支出面板调查（MEPS）的数据。确定了有自我报告的糖尿病和 CVD 病史的个体。

结果

仅 GLP-1RA 的使用从 2008 年（3%）稳定增加到 2019 年（21%），仅 SGLT2i 的使用从 2014 年（5%）稳定增加到 2019 年（12%）。同时使用两种新型 GLD 类别的个体从 2015 年的 0.62%增加到 2019 年的 6%。这两种新药在 2019 年的总体采用率不足 40%。换句话说，60%的能从这些新疗法中显著获益的个体没有使用这些治疗方法。