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Electronic medical records-based comparison of glycemic control efficacy between sulfonylureas and dipeptidyl peptidase-4 inhibitors added on to metformin monotherapy in patients with type 2 diabetes
Sulfonylurea (SU) and dipeptidyl peptidase-4 (DPP-4) inhibitors are most common secondary agents that are added to metformin monotherapy. Real-world studies have become increasingly important in providing evidence of treatment effectiveness in clinical practice and real-world data could help appropr...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Society for Clinical Pharmacology and Therapeutics
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781806/ https://www.ncbi.nlm.nih.gov/pubmed/33425803 http://dx.doi.org/10.12793/tcp.2020.28.e21 |
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author | Lee, Suhrin Lee, SeungHwan Jang, In-Jin Yu, Kyung-Sang Rhee, Su-jin |
author_facet | Lee, Suhrin Lee, SeungHwan Jang, In-Jin Yu, Kyung-Sang Rhee, Su-jin |
author_sort | Lee, Suhrin |
collection | PubMed |
description | Sulfonylurea (SU) and dipeptidyl peptidase-4 (DPP-4) inhibitors are most common secondary agents that are added to metformin monotherapy. Real-world studies have become increasingly important in providing evidence of treatment effectiveness in clinical practice and real-world data could help appropriate therapeutic information. Therefore, this study aims to compare the glycemic effectiveness of SU and DPP-4 inhibitors, which are added to metformin monotherapy in real clinical practice using electronic medical record (EMR) data. EMR data of type 2 diabetes patients treated at Seoul National University Hospital from December 2002 to December 2012 were retrieved and analyzed. The patients were divided into three groups: patients who maintained metformin monotherapy (M), and patients who added SU (MS) or DPP-4 inhibitors (MD) to metformin monotherapy. The mean change in HbA1c level, the proportion of patients achieving the HbA1c target < 7.0%, proportion of patients with treatment failure, and probability of treatment failure occurrence and changes in prescription were evaluated to compare glycemic control efficacy between SU and DPP-4 inhibitors. The MS showed significantly greater reduction in the Hb1Ac level than MD. The proportion of patients achieving HbA1c < 7.0% is higher in MD, whereas the proportion of patients with treatment failure was greater in MS. The probability of the treatment failure and probability of changes in the prescription were lower in MD than MS with hazard ratio of 0.499 and 0.579, respectively. In conclusion, this real-world study suggested that DPP-4 inhibitors are expected to show more durable glycemic control efficacy than SU in long-term use. |
format | Online Article Text |
id | pubmed-7781806 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Korean Society for Clinical Pharmacology and Therapeutics |
record_format | MEDLINE/PubMed |
spelling | pubmed-77818062021-01-08 Electronic medical records-based comparison of glycemic control efficacy between sulfonylureas and dipeptidyl peptidase-4 inhibitors added on to metformin monotherapy in patients with type 2 diabetes Lee, Suhrin Lee, SeungHwan Jang, In-Jin Yu, Kyung-Sang Rhee, Su-jin Transl Clin Pharmacol Original Article Sulfonylurea (SU) and dipeptidyl peptidase-4 (DPP-4) inhibitors are most common secondary agents that are added to metformin monotherapy. Real-world studies have become increasingly important in providing evidence of treatment effectiveness in clinical practice and real-world data could help appropriate therapeutic information. Therefore, this study aims to compare the glycemic effectiveness of SU and DPP-4 inhibitors, which are added to metformin monotherapy in real clinical practice using electronic medical record (EMR) data. EMR data of type 2 diabetes patients treated at Seoul National University Hospital from December 2002 to December 2012 were retrieved and analyzed. The patients were divided into three groups: patients who maintained metformin monotherapy (M), and patients who added SU (MS) or DPP-4 inhibitors (MD) to metformin monotherapy. The mean change in HbA1c level, the proportion of patients achieving the HbA1c target < 7.0%, proportion of patients with treatment failure, and probability of treatment failure occurrence and changes in prescription were evaluated to compare glycemic control efficacy between SU and DPP-4 inhibitors. The MS showed significantly greater reduction in the Hb1Ac level than MD. The proportion of patients achieving HbA1c < 7.0% is higher in MD, whereas the proportion of patients with treatment failure was greater in MS. The probability of the treatment failure and probability of changes in the prescription were lower in MD than MS with hazard ratio of 0.499 and 0.579, respectively. In conclusion, this real-world study suggested that DPP-4 inhibitors are expected to show more durable glycemic control efficacy than SU in long-term use. Korean Society for Clinical Pharmacology and Therapeutics 2020-12 2020-12-18 /pmc/articles/PMC7781806/ /pubmed/33425803 http://dx.doi.org/10.12793/tcp.2020.28.e21 Text en Copyright © 2020 Translational and Clinical Pharmacology https://creativecommons.org/licenses/by-nc/4.0/ It is identical to the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/). |
spellingShingle | Original Article Lee, Suhrin Lee, SeungHwan Jang, In-Jin Yu, Kyung-Sang Rhee, Su-jin Electronic medical records-based comparison of glycemic control efficacy between sulfonylureas and dipeptidyl peptidase-4 inhibitors added on to metformin monotherapy in patients with type 2 diabetes |
title | Electronic medical records-based comparison of glycemic control efficacy between sulfonylureas and dipeptidyl peptidase-4 inhibitors added on to metformin monotherapy in patients with type 2 diabetes |
title_full | Electronic medical records-based comparison of glycemic control efficacy between sulfonylureas and dipeptidyl peptidase-4 inhibitors added on to metformin monotherapy in patients with type 2 diabetes |
title_fullStr | Electronic medical records-based comparison of glycemic control efficacy between sulfonylureas and dipeptidyl peptidase-4 inhibitors added on to metformin monotherapy in patients with type 2 diabetes |
title_full_unstemmed | Electronic medical records-based comparison of glycemic control efficacy between sulfonylureas and dipeptidyl peptidase-4 inhibitors added on to metformin monotherapy in patients with type 2 diabetes |
title_short | Electronic medical records-based comparison of glycemic control efficacy between sulfonylureas and dipeptidyl peptidase-4 inhibitors added on to metformin monotherapy in patients with type 2 diabetes |
title_sort | electronic medical records-based comparison of glycemic control efficacy between sulfonylureas and dipeptidyl peptidase-4 inhibitors added on to metformin monotherapy in patients with type 2 diabetes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781806/ https://www.ncbi.nlm.nih.gov/pubmed/33425803 http://dx.doi.org/10.12793/tcp.2020.28.e21 |
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