Adoption of the ADA/EASD guidelines in 10 Eastern and Southern European countries: Physician survey and good clinical practice recommendations from an international expert panel

Banach, Maciej; Gaiță, Dan; Haluzı́k, Martin; Kamenov, Zdravko; Kempler, Péter; Lalić, Nebojša; Linhart, Aleš; Mikhailidis, Dimitri P.; Nocoń, Aleksandra; Silva-Nunes, José; Παπάνας, Νικόλαος; Raposo, João Filipe; Rizzo, Manfredi; Stoian, Anca Pantea

doi:10.1016/j.diabres.2020.108535

Cited by 15 publications

(10 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nonetheless, based on projections from the present analysis, use of oral semaglutide for the treatment of type 2 diabetes in place of empagliflozin or dulaglutide should deliver value for money for the NHS in Portugal. These results should help to influence health policy in Portugal and similar countries where GLP-1 receptor agonist and SGLT-2 inhibitor use is limited, despite their demonstrated efficacy [ 8 , 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

The long-term cost-effectiveness of oral semaglutide versus empagliflozin and dulaglutide in Portugal

Malkin¹,

Carvalho

Costa³

et al. 2022

Diabetol Metab Syndr

View full text Add to dashboard Cite

Background Oral semaglutide is a novel glucagon-like peptide-1 (GLP-1) analog that has been associated with improvements in glycated hemoglobin (HbA1c) and body weight versus sodium-glucose cotransporter-2 inhibitor empagliflozin and injectable GLP-1 receptor agonist dulaglutide in the PIONEER 2 clinical trial and in a recent network meta-analysis (NMA), respectively. The aim of the present study was to evaluate the long-term cost-effectiveness of oral semaglutide 14 mg versus empagliflozin 25 mg and dulaglutide 1.5 mg for the treatment of type 2 diabetes from a healthcare payer perspective in Portugal. Methods In two separate analyses, outcomes were projected over patients’ lifetimes using the IQVIA CORE Diabetes Model (v9.0), discounted at 4% per annum. Clinical data were sourced from the PIONEER 2 trial and the NMA for the comparisons versus empagliflozin and dulaglutide, respectively. Patients were assumed to receive initial therapies until HbA1c exceeded 7.5%, then treatment-intensified to solely basal insulin therapy. Costs were accounted from a National Healthcare Service perspective in Portugal and expressed in 2021 euros (EUR). Utilities were taken from published sources. Results Oral semaglutide 14 mg was associated with improvements in life expectancy of 0.10 and 0.03 years, and quality-adjusted life expectancy of 0.11 and 0.03 quality-adjusted life years (QALYs), versus empagliflozin 25 mg and dulaglutide 1.5 mg, respectively. Improved clinical outcomes were due to a reduced cumulative incidence and increased time to onset of diabetes-related complications with oral semaglutide. Total costs were projected to be EUR 2548 and EUR 814 higher with oral semaglutide versus empagliflozin and dulaglutide, with higher acquisition costs partially offset by cost savings from avoidance of diabetes-related complications. Oral semaglutide 14 mg was therefore associated with incremental cost-effectiveness ratios of EUR 23,571 and EUR 23,927 per QALY gained versus empagliflozin 25 mg and dulaglutide 1.5 mg, respectively. Conclusions Based on a willingness-to-pay threshold of EUR 30,000 per QALY gained, oral semaglutide 14 mg was considered cost-effective versus empagliflozin 25 mg and dulaglutide 1.5 mg for the treatment of type 2 diabetes in Portugal.

show abstract

Section: Discussionmentioning

confidence: 99%

The long-term cost-effectiveness of oral semaglutide versus empagliflozin and dulaglutide in Portugal

Malkin¹,

Carvalho

Costa³

et al. 2022

Diabetol Metab Syndr

View full text Add to dashboard Cite

show abstract

“…Most patients with a long history of T2D require intensified and combined treatment with oral antidiabetic drugs (OADs) over time, and some patients with T2D do not meet their glycaemic targets using a guideline‐based combination of OADs. Global guidelines, including those of the Korean Diabetes Association, recommend intensifying medication using injectable medication with a greater potency, including a glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) and/or insulin in T2D patients, if the target HbA1c level is not reached with two or more OADs 1,3,4 . Despite these recommendations, injectable medication is often perceived as a hurdle for both patients and clinical physicians because of numerous reasons, including old age with a decline in self‐management ability, injection‐site reactions, and a fear of needles and hypoglycaemia 5,6 .…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of teneligliptin added to patients with type 2 diabetes inadequately controlled by oral triple combination therapy: A multicentre, randomized, double‐blind, and placebo‐controlled study

Lee

Kim

et al. 2022

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

Aim: To investigate the effectiveness and safety of teneligliptin over placebo in patients with type 2 diabetes (T2D) inadequately controlled by triple therapy.Materials and Methods: This trial was a prospective, multicentre, randomized, doubleblind, placebo-controlled study. The 12-week double-blind period was followed by a 12week, open-label clinical trial. One hundred patients with T2D who failed to achieve the glycaemic target (7.1% ≤ HbA1c ≤ 9.0%) with conventional triple oral antidiabetic drugs (OADs) of metformin, sulphonylurea, and sodium-glucose co-transporter-2 inhibitor were assigned randomly 1:1 into teneligliptin and placebo-teneligliptin groups. The primary endpoint was mean change in HbA1c level from baseline in each group at 12 weeks.Results: For a total of 99 patients (n = 51 for the teneligliptin group, and n = 48 for the placebo-teneligliptin group), the mean age and duration of diabetes were 60.7 and 13.6 years, respectively, and HbA1c was 7.8% at baseline. At 12 weeks, the teneligliptin group achieved a significant reduction in HbA1c from baseline (À0.9% ± 0.6%, P < .001), with an intergroup difference of À0.75% compared with the placebo group (95% CI [-0.99%, -0.51%], P < .001). At the end of the 24-week treatment period, both groups showed significant reductions in HbA1c level from baseline (placebo-teneligliptin group, -0.8% ± 0.6% [P < .001], teneligliptin group, -0.9% ± 0.6% [P < .001]), without significant intergroup difference (À0.17%, 95% CI [À0.41%, 0.07%], P = .156). There was no significant difference between the groups in the rate of adverse events (placeboteneligliptin group, n = 3 [6.3%]; teneligliptin group, n = 11 [11.1%]; P = .550), and the safety profiles were favourable in both groups. Conclusions:The current study shows that teneligliptin could be a valid option as a fourth OAD for the treatment of patients with T2D inadequately controlled with a triple combination of OADs. K E Y W O R D S antidiabetic drug, DPP-4 inhibitor, randomized trial, type 2 diabetes Minyoung Lee and Woo-je Lee contributed equally to this work.

show abstract

“…Indeed, many patients perceive any injectable therapy as similar to insulin therapy, thus rejecting any injectable therapy. This has been proposed by many authors as an explanation for the slow adoption in clinical practice of the most recent recommendations from international scientific guidelines on diabetes, which have emphasized for several years the importance of early treatment with GLP-1 receptor agonists [36,38]. We are aware that most patients usually prefer oral pills and not injections, with the majority afraid of needles, even if the injection is once weekly.…”

Section: Discussionmentioning

confidence: 99%

Effect of Oral Semaglutide on Cardiovascular Parameters and Their Mechanisms in Patients with Type 2 Diabetes: Rationale and Design of the Semaglutide Anti-Atherosclerotic Mechanisms of Action Study (SAMAS)

et al. 2022

Self Cite

View full text Add to dashboard Cite

Introduction: Type 2 diabetes (T2D) management has reached a point where not only optimal glycaemic control is necessary, but also additional interventions with proven cardiovascular risk reduction benefit. Subcutaneous semaglutide has been shown to provide cardiovascular protection, but its use may be limited by its injection formulation. To overcome this limitation, an oral semaglutide tablet has been developed, which could potentially be of the same value as its injection counterpart, but in a much wider group of patients with T2D, thereby allowing for broader cardiovascular risk reduction in this vulnerable patient population. Methods: A total of 100 consecutive patients with T2D and a disease duration of up to 10 years, without manifest cardiovascular disease, who are treated with metformin (± sulphonylurea) and optimal cardioprotective therapy, will be recruited in a single-blinded, randomized trial named ''Semaglutide Antiatherosclerotic Mechanisms of Action Study (SAMAS).'' After 1:1 randomization, patients will receive either oral semaglutide 14 mg daily or placebo for 1 year. The primary outcome comprises changes in atherosclerosis-related structural and functional characteristics of the arterial wall, namely: reduction of the carotid intima-media thickness, improvement of endothelial function and decrease in arterial stiffness. Secondary outcomes are changes in atherogenic small dense low-density lipoproteins, glucose control (HbA1c) and inflammatory markers (hsCRP). Possible correlations between primary endpoints and changes in

show abstract

Adoption of the ADA/EASD guidelines in 10 Eastern and Southern European countries: Physician survey and good clinical practice recommendations from an international expert panel

Cited by 15 publications

References 29 publications

The long-term cost-effectiveness of oral semaglutide versus empagliflozin and dulaglutide in Portugal

The long-term cost-effectiveness of oral semaglutide versus empagliflozin and dulaglutide in Portugal

Effectiveness and safety of teneligliptin added to patients with type 2 diabetes inadequately controlled by oral triple combination therapy: A multicentre, randomized, double‐blind, and placebo‐controlled study

Effect of Oral Semaglutide on Cardiovascular Parameters and Their Mechanisms in Patients with Type 2 Diabetes: Rationale and Design of the Semaglutide Anti-Atherosclerotic Mechanisms of Action Study (SAMAS)

Contact Info

Product

Resources

About