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Patterns and trends of utilization of incretin-based medicines between 2008 and 2014 in three Italian geographic areas
BACKGROUND: The incretin-based medicines GLP1 analogues (GLP1a) and dipeptidyl peptidase-4 inhibitors (DPP4i) are hypoglycaemic agents licensed for the treatment of type 2 diabetes mellitus (T2DM). Although these drugs possess comparable efficacy and low risk of hypoglycaemia, differences in terms o...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367760/ https://www.ncbi.nlm.nih.gov/pubmed/30732592 http://dx.doi.org/10.1186/s12902-019-0334-y |
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author | Roberto, Giuseppe Barone-Adesi, Francesco Giorgianni, Francesco Pizzimenti, Valeria Ferrajolo, Carmen Tari, Michele Bartolini, Claudia Da Cas, Roberto Maggini, Marina Spila-Alegiani, Stefania Francesconi, Paolo Trifirò, Gianluca Poluzzi, Elisabetta Baccetti, Fabio Gini, Rosa |
author_facet | Roberto, Giuseppe Barone-Adesi, Francesco Giorgianni, Francesco Pizzimenti, Valeria Ferrajolo, Carmen Tari, Michele Bartolini, Claudia Da Cas, Roberto Maggini, Marina Spila-Alegiani, Stefania Francesconi, Paolo Trifirò, Gianluca Poluzzi, Elisabetta Baccetti, Fabio Gini, Rosa |
author_sort | Roberto, Giuseppe |
collection | PubMed |
description | BACKGROUND: The incretin-based medicines GLP1 analogues (GLP1a) and dipeptidyl peptidase-4 inhibitors (DPP4i) are hypoglycaemic agents licensed for the treatment of type 2 diabetes mellitus (T2DM). Although these drugs possess comparable efficacy and low risk of hypoglycaemia, differences in terms of route of administration (subcutaneous versus oral), effect on body weight and gastrointestinal tolerabily can impact their actual use in clinical practice. This study aimed to describe the real-world utilization of incretin-based medicines in the Italian clinical practice. METHODS: A multi-database, population-based, descriptive, cohort study was performed using administrative data collected between 2008 and 2014 from three Italian geographic areas. Subjects aged ≥18 were selected. New users were defined as those with ≥1 dispensing of GLP1a or DPP4i during the year of interest and none in the past. Trends of cumulative annual incidence of use in the general adult population were observed. New users of GLP1a or DPP4i were respectively described in terms of demographic characteristics and use of antidiabetic drugs during 1 year before and after the first incretin dispensing. RESULTS: The overall study population included 4,943,952 subjects. A total of 7357 new users of GLP1a and 41,907 of DPP4i were identified during the study period. Incidence of use increased between 2008 (0.2‰ for both GLP1a and DPP4i) and 2011 (GLP1a = 0.6‰; DPP4i = 2.5‰) and slightly decreased thereafter. In 2014, 61% of new GLP1a users received once-daily liraglutide while 52% of new DPP4i users received metformin/DPP4i in fixed-dose. The percentage of new DPP4i users older than 65 years of age increased from 30.9 to 62.6% during the study period. Around 12% of new users had not received any antidiabetic before starting an incretin. CONCLUSIONS: During the study period, DPP4i rapidly became the most prescribed incretin-based medicine, particularly among older new user. The choice of the specific incretin-based medicine at first prescription appeared to be directed towards those with higher convenience of use (e.g. oral DPP4i rather than subcutaneous GLP1a, once-daily liraglutide rather than twice-daily exenatide). The non-negligibile use of incretin-based medicines as first-line pharmacotherapy for T2DM warrants further effectiveness and safety evaluations to better define their place in therapy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12902-019-0334-y) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6367760 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63677602019-02-15 Patterns and trends of utilization of incretin-based medicines between 2008 and 2014 in three Italian geographic areas Roberto, Giuseppe Barone-Adesi, Francesco Giorgianni, Francesco Pizzimenti, Valeria Ferrajolo, Carmen Tari, Michele Bartolini, Claudia Da Cas, Roberto Maggini, Marina Spila-Alegiani, Stefania Francesconi, Paolo Trifirò, Gianluca Poluzzi, Elisabetta Baccetti, Fabio Gini, Rosa BMC Endocr Disord Research Article BACKGROUND: The incretin-based medicines GLP1 analogues (GLP1a) and dipeptidyl peptidase-4 inhibitors (DPP4i) are hypoglycaemic agents licensed for the treatment of type 2 diabetes mellitus (T2DM). Although these drugs possess comparable efficacy and low risk of hypoglycaemia, differences in terms of route of administration (subcutaneous versus oral), effect on body weight and gastrointestinal tolerabily can impact their actual use in clinical practice. This study aimed to describe the real-world utilization of incretin-based medicines in the Italian clinical practice. METHODS: A multi-database, population-based, descriptive, cohort study was performed using administrative data collected between 2008 and 2014 from three Italian geographic areas. Subjects aged ≥18 were selected. New users were defined as those with ≥1 dispensing of GLP1a or DPP4i during the year of interest and none in the past. Trends of cumulative annual incidence of use in the general adult population were observed. New users of GLP1a or DPP4i were respectively described in terms of demographic characteristics and use of antidiabetic drugs during 1 year before and after the first incretin dispensing. RESULTS: The overall study population included 4,943,952 subjects. A total of 7357 new users of GLP1a and 41,907 of DPP4i were identified during the study period. Incidence of use increased between 2008 (0.2‰ for both GLP1a and DPP4i) and 2011 (GLP1a = 0.6‰; DPP4i = 2.5‰) and slightly decreased thereafter. In 2014, 61% of new GLP1a users received once-daily liraglutide while 52% of new DPP4i users received metformin/DPP4i in fixed-dose. The percentage of new DPP4i users older than 65 years of age increased from 30.9 to 62.6% during the study period. Around 12% of new users had not received any antidiabetic before starting an incretin. CONCLUSIONS: During the study period, DPP4i rapidly became the most prescribed incretin-based medicine, particularly among older new user. The choice of the specific incretin-based medicine at first prescription appeared to be directed towards those with higher convenience of use (e.g. oral DPP4i rather than subcutaneous GLP1a, once-daily liraglutide rather than twice-daily exenatide). The non-negligibile use of incretin-based medicines as first-line pharmacotherapy for T2DM warrants further effectiveness and safety evaluations to better define their place in therapy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12902-019-0334-y) contains supplementary material, which is available to authorized users. BioMed Central 2019-02-07 /pmc/articles/PMC6367760/ /pubmed/30732592 http://dx.doi.org/10.1186/s12902-019-0334-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Roberto, Giuseppe Barone-Adesi, Francesco Giorgianni, Francesco Pizzimenti, Valeria Ferrajolo, Carmen Tari, Michele Bartolini, Claudia Da Cas, Roberto Maggini, Marina Spila-Alegiani, Stefania Francesconi, Paolo Trifirò, Gianluca Poluzzi, Elisabetta Baccetti, Fabio Gini, Rosa Patterns and trends of utilization of incretin-based medicines between 2008 and 2014 in three Italian geographic areas |
title | Patterns and trends of utilization of incretin-based medicines between 2008 and 2014 in three Italian geographic areas |
title_full | Patterns and trends of utilization of incretin-based medicines between 2008 and 2014 in three Italian geographic areas |
title_fullStr | Patterns and trends of utilization of incretin-based medicines between 2008 and 2014 in three Italian geographic areas |
title_full_unstemmed | Patterns and trends of utilization of incretin-based medicines between 2008 and 2014 in three Italian geographic areas |
title_short | Patterns and trends of utilization of incretin-based medicines between 2008 and 2014 in three Italian geographic areas |
title_sort | patterns and trends of utilization of incretin-based medicines between 2008 and 2014 in three italian geographic areas |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367760/ https://www.ncbi.nlm.nih.gov/pubmed/30732592 http://dx.doi.org/10.1186/s12902-019-0334-y |
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