Comparison of heart failure risk and medical costs between patients with type 2 diabetes mellitus treated with dapagliflozin and dipeptidyl peptidase-4 inhibitors: a nationwide population-based cohort study

Seong, Jong-Mi; Kim, Jong Joo; Kim, Hae Jin; Sohn, Hyun Soon

doi:10.1186/s12933-020-01060-1

Cited by 16 publications

(13 citation statements)

References 39 publications

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“…Medical treatment data consisted of electronic bills for the medical treatment provided, prescription of drugs, and diagnosis codes (as defined by the International Classification of Diseases, 10th revision), as well as treatment costs for claims. Therefore, almost all information about patients and diseases could be obtained from the Korean NHIS database, and this database was used in many epidemiological studies [ 11 , 12 , 13 , 14 ]. This study was conducted according to the guidelines of the Declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

Effect of Dosing Interval on Compliance of Osteoporosis Patients on Bisphosphonate Therapy: Observational Study Using Nationwide Insurance Claims Data

Lee

Kim

et al. 2021

JCM

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Only a few studies are available on the effect of the dosing interval of bisphosphonate on drug compliance. We analyzed the data of patients who were newly prescribed bisphosphonate using a national insurance claims database. Drug compliance was assessed by calculating medication possession ratio (MPR) over a minimum of a 1-year follow-up. This analysis included 281,996 new bisphosphonate users with a mean age of 68.9 years (92% women). The patients were divided into daily, weekly, monthly, 3-monthly, and switch groups (who changed the drug to other dosing intervals). The average MPR was the highest in the switch group (66%), and the longer the dosing interval, the higher the compliance (3-monthly, 56% vs. daily, 37%). “Non-compliant” was defined as an MPR under 80%. Various factors which were possibly associated with “non-compliant” MPR were investigated using multiple regression analysis. Multivariate analysis showed that male patients were more likely to be non-compliant with pharmacotherapy than female patients, with as odds ratio of 1.389. Younger patients had a significantly lower likelihood of being non-compliant than older patients for age 60–69 vs. age 80+. Long dosing intervals were recommended to improve compliance and special attention was given to older and male patients.

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Section: Methodsmentioning

confidence: 99%

Effect of Dosing Interval on Compliance of Osteoporosis Patients on Bisphosphonate Therapy: Observational Study Using Nationwide Insurance Claims Data

Lee

Kim

et al. 2021

JCM

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“…The study protocol was approved by the CHA University Institutional Review Board (protocol ID: 1044308-201812-HR-060-01). Prior research on HF risk has been published previously ( Seong et al, 2020 ).…”

Section: Methodsmentioning

confidence: 99%

Risk of Cardiovascular Events and Medical Cost of Dapagliflozin and Dipeptidyl Peptidase-4 Inhibitors

Seong

Kim

et al. 2021

Front. Pharmacol.

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This study compared dapagliflozin, a sodium-glucose co-transporter 2 inhibitor, and dipeptidyl peptidase-4 inhibitors (DPP-4i) with regard to cardiovascular (CV) event incidence and direct medical costs during type 2 diabetes treatment. A retrospective cohort study was conducted using national health insurance claims data from September 1, 2014, to June 30, 2018, of patients in Korea. Patients who were prescribed dapagliflozin and DPP-4i for the first time were included. The primary outcome was the incidence of a composite of major adverse CV events (MACEs)—nonfatal myocardial infarction, nonfatal stroke, or in-hospital CV death. Proportional hazard models after propensity score weighting were used to determine hazard ratios (HRs) and 95% confidence intervals (CIs) for MACE in the dapagliflozin and DPP-4i groups. A decision analytic model was used to compare direct medical costs between the two treatment groups from a healthcare provider’s perspective. Of the 260,336 patients in the cohort, 23,147 and 237,189 received dapagliflozin and DPP-4i, respectively. During the follow-up, 184 patients receiving dapagliflozin and 3,674 receiving DPP-4i (incidence, 6.47 and 11.33 events/1,000 person-years, respectively) had MACE. The adjusted HR of MACE for dapagliflozin compared with that for DPP-4i was 0.69 (95% CI 0.57–0.83). The corresponding HRs were consistent among patients with and without underlying CV disease. The estimated direct medical cost appeared to be lower by $68,452 in the dapagliflozin group than that in the DPP-4i group for 3 years, in 1,000 hypothetical patients. In this population-based cohort study, the use of dapagliflozin instead of DPP-4i was associated with a reduced risk of MACE, which subsequently reduced direct medical costs. These data provide valuable information to patients, practitioners, and authorities regarding the risk of CV events associated with dapagliflozin versus DPP-4i use in clinical practice.

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“…Populations level studies have also indicated a significant reduction in the risk of heart failure in T2DM patients with SGLT2 inhibitors when compared to DPP-4 inhibitors suggesting a cardioprotective effect of SGLT2 inhibitors. 138,139…”

Section: Sglt2 Inhibitorsmentioning

confidence: 99%

Role of diabetes in stroke: Recent advances in pathophysiology and clinical management

Bradley

Spring

Beran

et al. 2021

Diabetes Metabolism Res

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The increasing prevalence of diabetes and stroke is a major global public health concern. Specifically, acute stroke patients, with pre-existing diabetes, pose a clinical challenge. It is established that diabetes is associated with a worse prognosis after acute stroke and the various biological factors that mediate poor recovery profiles in diabetic patients is unknown. The level of association and impact of diabetes, in the setting of reperfusion therapy, is yet to be determined. This article presents a comprehensive overview of the current knowledge of the role of diabetes in stroke, therapeutic strategies for primary and secondary prevention of cardiovascular disease and/or stroke in diabetes, and various therapeutic considerations that may apply during pre-stroke, acute, sub-acute and post-stroke stages. The early diagnosis of diabetes as a comorbidity for stroke, as well as tailored post-stroke management of diabetes, is pivotal to our efforts to limit the burden. Increasing awareness and involvement of neurologists in the management of diabetes and other cardiovascular risk factors is desirable towards improving stroke prevention and efficacy of reperfusion therapy in acute stroke patients with diabetes.

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Comparison of heart failure risk and medical costs between patients with type 2 diabetes mellitus treated with dapagliflozin and dipeptidyl peptidase-4 inhibitors: a nationwide population-based cohort study

Cited by 16 publications

References 39 publications

Effect of Dosing Interval on Compliance of Osteoporosis Patients on Bisphosphonate Therapy: Observational Study Using Nationwide Insurance Claims Data

Effect of Dosing Interval on Compliance of Osteoporosis Patients on Bisphosphonate Therapy: Observational Study Using Nationwide Insurance Claims Data

Risk of Cardiovascular Events and Medical Cost of Dapagliflozin and Dipeptidyl Peptidase-4 Inhibitors

Role of diabetes in stroke: Recent advances in pathophysiology and clinical management

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