Quality goal attainment and maintenance in patients with type II diabetes mellitus initiated on canagliflozin or a glucagon-like peptide-1 receptor agonist in an actual practice setting.
Quality goal attainment and maintenance in patients with type II diabetes mellitus initiated on canagliflozin or a glucagon-like peptide-1 receptor agonist in an actual practice setting. Curr Med Res Opin. 2018 Mar 20;:1-24 Authors: Wysham CH, Pilon D, Ingham M, Lafeuille MH, Emond B, Kamstra R, Pfeifer M, Lefebvre P Abstract OBJECTIVE: To compare achievement of quality goals (HbA1c, weight loss/body mass index[BMI], systolic blood pressure[SBP]), including maintaining HbA1c, between patients with type 2 diabetes mellitus (T2DM) treated with canagliflozin 300mg (CANA) or a GLP-1 in an actual practice setting. METHODS: Adults with T2DM newly initiated on CANA or a GLP-1 were identified from the IQVIATM Real-World Data Electronic Medical Records – US database (2012Q2-2016Q1). To account for differences in baseline characteristics, inverse probability of treatment weighting was used. Outcomes were compared using Cox models (hazard ratios [HRs] and 95% confidence intervals [CIs]) and Kaplan-Meier analyses. RESULTS: CANA (N = 11,435) and GLP-1 (N = 11,582) cohorts had similar attainment of HbA1c < 8.0% (64mmol/mol) and HbA1c < 9.0% (75mmol/mol; HbA1c < 8.0%: HR[CI] = 0.98[0.91;1.06]; HbA1c < 9.0%: HR[CI] = 1.02[0.93;1.12]) while GLP-1 patients were 10% more likely to achieve HbA1c < 7.0% (53mmol/mol). CANA and GLP-1 patients were similar in maintaining HbA1c < 7.0%, <8.0%, or <9.0%, achieving weight loss≥5% (HR[CI] = 1.05[0.99;1.12]), achieving BMI < 30kg/m2 (HR[CI] = 1.11[0.98;1.27]), and achieving SBP < 140mmHg (HR[CI] = 1.07[0.98;1.17]). CANA patients were 30% less likely to discontinue treatment, 28% less likely to have a prescription for a new antihyperglycemic, and 17-21% less likely to fail to maintain HbA1c < 8.0%...Read More