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Prescribing Trends of Antidiabetes Medications in Patients With Type 2 Diabetes and Diabetic Kidney Disease, a Cohort Study

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posted on 03.08.2021, 15:31 by Samantha T. Harris, Elisabetta Patorno, Min Zhuo, Seoyoung C. Kim, Julie M. Paik
Objective: To assess changes in anti-diabetes medication class prescriptions over time among patients with Diabetic Kidney Disease (DKD), characteristics of patients prescribed these medications, and prescribers’ specialty.

Methods: A cohort study design using insurance claims data between 2013 and the first quarter (Q1) of 2020. Included are adult patients with DKD who initiated a new anti-diabetes medication between 2013 and 2020Q1 (N=160,489 patients). The primary outcome is the yearly and quarterly percent of medication initiation for each anti-diabetes medication class over all anti-diabetes medication initiations.

Research Design and Results: For patients with DKD, sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide 1-receptor agonists (GLP-1RA) initiations steadily increased between 2013 and 2020Q1. Internists and endocrinologists were the most frequent prescriber specialties. Patients less than 65 years of age had a larger percentage of all initiations that were SGLT2i or GLP-1RA, 16% and 23% respectively in 2019, and patients older than 75 years had a smaller percentage of all initiations that were SGLT2i or GLP-1RA, 11% and 13% respectively in 2019.

Conclusions: For patients with DKD, SGLT2i and GLP-1RA prescriptions have increased over time, likely reflecting evolving prescribing patterns in response to the results of recent clinical trials and new clinical guidelines.

Funding

This study was funded by the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA. EP was supported by a career development grant (K08AG055670) from the National Institute on Aging. MZ was supported by a Institutional Research Grant (DK007199) from the National Institute of Health. None of these funding sources had any role in the design or conduct of the study, collection, management, analysis, and interpretation of the data, preparation, review or approval of the manuscript, or decision to submit the manuscript for publication.

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