Comparing medication persistence among patients with T2D using sodium-glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists in real-world setting
Several strategies, including diet, exercise, and drug therapy have been used in managing diabetes. While metformin is the first line of treatment, recent data suggests that glucagon-like peptide-1 receptor agonists (GLP1-RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2-I) reduces the incidence of cardiovascular events in patients with type 2 diabetes. However, the use of these drugs was linked with the events such as nausea and vomiting that decreased its implication in clinical practice. Federico Rea and colleagues conducted research under the title “Comparing medication persistence among patients with type 2 diabetes using sodium-glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists in real-world setting” published in the journal of Diabetes Research and Clinical Practice. The summary of this research is given below:
To investigate and compare the endurance with drug therapy between patients treated
with sodium-glucose cotransporter-2 inhibitors (SGLT2-I) and glucagon-like peptide-1 receptor agonists (GLP1-RA) therapy.
The study included 126,493 residents of the Lombardy Region (Italy) with 40 years of age newly treated with metformin during 2007–2015. They were followed until 2017 to recognize subjects who started therapy with GLP1-RA or SGLT2-I. A 1:1 matched cohort design was used to compare GLP1-RA and SGLT2-I effect. Age, sex, and adherence to the first-line therapy with metformin was matched variable among subjects. Log-binomial regression models were used to investigate the susceptibility to 1-year treatment persistence in relation to the therapeutic strategy.
This study confirms that the discontinuation rate is high with GLP1-RA and SGLT2-I treatment in ‘real-life’ practice. This study came up with three new findings. First, more subjects were discontinued in the SGLT2-I group than the GLP1-RA group. Secondly, only a few patients completely interrupted the antidiabetic drug therapy post discontinuation. Thirdly, a higher number of patients discontinued any antidiabetic treatment during the 1st year from starting and this is of concern because adherence to treatment leads to improvement in glycemic control.
The major limitation is that study unable to explain the reason behind the discontinuation of therapy.
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