Bhat Khurshid A, Singh Kiran P, Maddukuri Hanumantha Rao, Routray S N, Sharma Shreya, Sharma Surendra Kumar, Patel Kamlesh, Kinare Veena, Mate Pradip, Lokesh Kumar R V
Department of Endocrinology, Pearl Pharmacy, Hyderpora, IND.
Diabetes and Endocrinology, Fortis Medcenter, Chandigarh, IND.
Cureus. 2024 Nov 30;16(11):e74820. doi: 10.7759/cureus.74820. eCollection 2024 Nov.
Objectives The study was conducted to generate real-world data on prescription patterns and patient profiles for sitagliptin-based therapies in real-world outpatient settings across India. Method A cross-sectional, observational, multicenter, real-world prescription event monitoring (PEM) study was conducted at 1058 sites across India over six months, from 1 August 2023 to 16 January 2024. Adult type 2 diabetes patients receiving sitagliptin-based mono or combination therapies were included in the study. Primary outcomes assessed included the dosage of sitagliptin and other medications and the specific drugs combined with sitagliptin. Secondary outcomes included demographic profiles, medication history, comorbidities, and glycemic parameters. Results A total of 10210 patients (n=6398 males; n=3812 females) completed the study. Duration of diabetes was available for 5422 patients, of which nearly half of the patients had diabetes for 1-5 years, while around 42.3% (n=2294) of the patients had diabetes for more than five years. Comorbidities were present in 36.02% (n=3678) of the patients. Hypertension and dyslipidemia were the most common comorbidities reported in 25.3% (n=2584) and 10.42% (n=1064), respectively. Sitagliptin was administered as monotherapy or in combination with other medications. Dual combination therapy was most common, with sitagliptin 50 mg+metformin 500 mg being the predominantly prescribed regimen. Triple combination therapy with sitagliptin+dapagliflozin+metformin was also prescribed in a substantial proportion of the patients. Variations in preferred regimens were observed among patients with different comorbid conditions, with sitagliptin 100 mg+dapagliflozin 10 mg being preferred in patients with established cardiovascular disease and heart failure and sitagliptin 50 mg+metformin 500 mg in diabetic patients with hypertension, dyslipidemia, and renal disease. Conclusion The study findings highlighted the preferences for the use of sitagliptin and its dual as well as triple combinations as integral components of diabetes management strategies in clinical practice in Indian outpatient settings. The study also found that diabetes with ASCVD and CV risk factors influence the use of sitagliptin and dapagliflozin in combination.
本研究旨在收集印度各地真实世界门诊环境中基于西他列汀治疗的处方模式和患者概况的真实世界数据。方法：2023年8月1日至2024年1月16日，在印度1058个地点进行了一项为期六个月的横断面、观察性、多中心真实世界处方事件监测（PEM）研究。纳入接受基于西他列汀的单药或联合治疗的成年2型糖尿病患者。评估的主要结局包括西他列汀和其他药物的剂量以及与西他列汀联合使用的特定药物。次要结局包括人口统计学概况、用药史、合并症和血糖参数。结果：共有10210名患者（n = 6398名男性；n = 3812名女性）完成了研究。5422名患者有糖尿病病程数据，其中近一半患者患糖尿病1 - 5年，约42.3%（n = 2294）的患者患糖尿病超过五年。36.02%（n = 3678）的患者存在合并症。高血压和血脂异常是最常见的合并症，分别有25.3%（n = 2584）和10.42%（n = 1064）的患者报告患有这两种疾病。西他列汀作为单药治疗或与其他药物联合使用。双联联合治疗最为常见，西他列汀50 mg + 二甲双胍500 mg是主要的处方方案。相当一部分患者还使用了西他列汀 + 达格列净 + 二甲双胍的三联联合治疗。在不同合并症患者中观察到了首选方案的差异，患有确诊心血管疾病和心力衰竭的患者更倾向于使用西他列汀100 mg + 达格列净10 mg，而患有高血压、血脂异常和肾病的糖尿病患者更倾向于使用西他列汀50 mg + 二甲双胍500 mg。结论：研究结果突出了在印度门诊临床实践中，使用西他列汀及其双联和三联联合方案作为糖尿病管理策略组成部分的偏好。研究还发现，伴有动脉粥样硬化性心血管疾病（ASCVD）和心血管风险因素的糖尿病会影响西他列汀和达格列净联合使用的情况。
