Dipeptidyl peptidase‐4 inhibitors as preferable oral hypoglycemic agents in terms of treatment satisfaction: Results from a multicenter, 12‐week, open label, randomized controlled study in Japan (PREFERENCE 4 study)

Abstract

Aims/IntroductionTo compare the treatment satisfaction of four classes of oral hypoglycemic agents (OHAs): dipeptidyl peptidase‐4 (DPP‐4) inhibitors, α‐glucosidase inhibitors (αGI), biguanides (BG) and sulfonylureas (SU), which are common initial treatments for type 2 diabetes mellitus patients in Japan, and to identify the best oral hypoglycemic agent in terms of treatment satisfaction.Materials and MethodsIn this 12‐week, randomized, controlled, open‐label study, Japanese outpatients with type 2 diabetes mellitus who were naïve to pharmacological treatment were randomly assigned a DPP‐4 inhibitor, a BG., an αGI or a SU. The primary end‐point was the Oral Hypoglycemic Agent Questionnaire (OHA‐Q) total and subscale scores (treatment convenience, somatic symptoms and satisfaction) at week 4. Adherence, glycated hemoglobin (HbA1c) level and safety were also evaluated.ResultsThe DPP‐4 inhibitor group scored highest in the OHA‐Q total and all subscale scores at week 4. The total score was significantly higher in the DPP‐4 inhibitor group than in the BG or αGI groups (P = 0.0084 and 0.0147, respectively). The mean total score at week 12 was also highest in the DPP‐4 inhibitor group, with a significant difference compared with the αGI group (P = 0.0293). The mean HbA1c decreased from baseline to week 12 in all groups. The DPP‐4 inhibitor group had the highest adherence at weeks 4 and 12. A total of 11 patients reported adverse events, including one hypoglycemic event in the SU group.ConclusionsThe DPP‐4 inhibitor was the most preferable option in terms of treatment satisfaction.

Treatment patterns, persistence and adherence rates in patients with type 2 diabetes mellitus in Japan: a claims-based cohort study

“…For example, the ATTAK-J study reported real-world evidence of significant hypoglycaemic activity and favourable safety for DPP-4i therapy in Japanese patients with T2DM 25. The PREFERENCE 4 study documented that treatment-naive Japanese patients preferred (in terms of treatment satisfaction) a DPP-4i to a BG, SU, or α-GI 26. Use of a weekly DPP-4i also improved treatment satisfaction 27 28.…”

Factors associated with treatment satisfaction in patients with type 2 diabetes mellitus using oral glucose-lowering agents: a cross-sectional study in urban districts in Japan

“…First, it is a crosssectional observation study, thus no causality can be determined. Ishii et al [12] have reported recently a randomized controlled study to identify the best OGLA associated with treatment satisfaction and concluded that DPP-4i was the most preferable option for initial treatment among SU, BG, αGI, and DPP4i. However, the use of SGLT2i was not evaluated in their study.…”

Persistence of oral antidiabetic treatment for type 2 diabetes characterized by drug class, patient characteristics and severity of renal impairment: A Japanese database analysis

“…[CI] 46-66), with estimates ranging from 41% to 81%. 12 Although treatment adherence and persistence may be assessed as part of rigorously controlled clinical trials involving specific patient populations with diabetes, 13 reports of real-world OAD adherence and persistence rates are limited, particularly in Japan. 14,15 To our knowledge, this is the first large-scale, real-world evaluation of treatment persistence, patient characteristics and severity of RI among classes of OADs in T2DM patients in Japan.…”