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Adherence to GLP1-RA and SGLT2-I affects clinical outcomes and costs in patients with type 2 diabetes

Adherence to GLP1-RA and SGLT2-I affects clinical outcomes and costs in patients with type 2 diabetes

Authors :
Ciardullo, S
Savaré, L
Rea, F
Perseghin, G
Corrao, G
Ciardullo, Stefano
Savaré, Laura
Rea, Federico
Perseghin, Gianluca
Corrao, Giovanni
Ciardullo, S
Savaré, L
Rea, F
Perseghin, G
Corrao, G
Ciardullo, Stefano
Savaré, Laura
Rea, Federico
Perseghin, Gianluca
Corrao, Giovanni
Publication Year :
2024

Abstract

Aims: To evaluate the impact of adherence to glucagon like peptide-1 receptor agonists (GLP1-RA) and sodium-glucose transporter two inhibitors (SGLT2-I) on clinical outcomes and costs in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: The 121,115 residents of the Lombardy Region (Italy) aged ≥40 years newly treated with metformin during 2007–2015 were followed to identify those who started therapy with GLP1-RA or SGLT2-I. Adherence to drug therapy over the first year was defined as the proportion of days covered >80%. Within each drug class, for each adherent patient, one non-adherent patient was matched for age, sex, duration, adherence to metformin treatment and propensity score. The primary clinical outcome was a composite of insulin initiation, hospitalisation for micro- and macrovascular complications and all-cause mortality after the first year of drug treatment. Costs were evaluated based on reimbursements from the national healthcare system. Results: After matching, 1182 pairs of adherent and non-adherent GLP1-RA users and 1126 pairs of adherent and non-adherent SGLT2-I users were included. In both groups, adherent patients experienced a significantly lower incidence of the primary outcome (HR: 0.85, 95% CI 0.72–0.98 for GLP1-RA and HR: 0.69, 95% CI 0.55–0.87 for SGLT2-I). A significant reduction in hospitalizations was found for adherent patients in the GLP1-RA group but not for the SGLT2-I group. Results were consistent when analyses were stratified by age and sex. While higher drug-related costs in the adherent group were counterbalanced by decreased hospitalisation costs in SGLT2-I treated patients, this was not the case for GLP1-RA. Conclusions: Higher adherence to drug treatment with GLP1-RA and SGLT2-I during the first year of the drug intake is associated with a lower incidence of adverse clinical outcomes in a real-world setting.

Details

Database :
OAIster
Notes :
STAMPA, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1434546877
Document Type :
Electronic Resource