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Comparing the effectiveness and cost-effectiveness of sulfonylureas and newer diabetes drugs as second-line therapy for patients with type 2 diabetes.
Franchi, Matteo; Pellegrini, Giacomo; Avogaro, Angelo; Buzzetti, Giuliano; Candido, Riccardo; Cavaliere, Arturo; Consoli, Agostino; Marzona, Irene; Mennini, Francesco Saverio; Palcic, Stefano; Corrao, Giovanni.
Afiliación
  • Franchi M; Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy matteo.franchi@unimib.it.
  • Pellegrini G; National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy.
  • Avogaro A; Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
  • Buzzetti G; National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy.
  • Candido R; Department of Medicine, Division of Metabolic Diseases, University of Padova, Padua, Italy.
  • Cavaliere A; Dephaforum, Milan, Italy.
  • Consoli A; Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
  • Marzona I; SC Patologie Diabetiche, ASUGI, Trieste, Italy.
  • Mennini FS; Farmaceutica Aziendale, ASL 9 Viterbo, Viterbo, Italy.
  • Palcic S; DMSI and CAST, Università degli Studi Gabriele d'Annunzio Chieti-Pescara, Chieti, Italy.
  • Corrao G; Dephaforum, Milan, Italy.
BMJ Open Diabetes Res Care ; 12(3)2024 May 27.
Article en En | MEDLINE | ID: mdl-38802266
ABSTRACT

INTRODUCTION:

We aimed to compare the effectiveness and cost-effectiveness profiles of glucagon-like peptide-1 receptor agonist (GLP-1-RA), sodium-glucose cotransporter 2 inhibitor (SGLT2i), and dipeptidyl peptidase-4 inhibitor (DPP-4i) compared with sulfonylureas and glinides (SU). RESEARCH DESIGN AND

METHODS:

Population-based retrospective cohort study based on linked regional healthcare utilization databases. The cohort included all residents in Lombardy aged ≥40 years, treated with metformin in 2014, who started a second-line treatment between 2015 and 2018 with SU, GLP-1-RA, SGLT2i, or DPP-4i. For each cohort member who started SU, one patient who began other second-line treatments was randomly selected and matched for sex, age, Multisource Comorbidity Score, and previous duration of metformin treatment. Cohort members were followed up until December 31, 2022. The association between second-line treatment and clinical outcomes was assessed using Cox proportional hazards models. The incremental cost-effectiveness ratios (ICERs) were calculated and compared between newer diabetes drugs and SU.

RESULTS:

Overall, 22 867 patients with diabetes were included in the cohort, among which 10 577, 8125, 2893 and 1272 started a second-line treatment with SU, DPP-4i, SGLT2i and GLP-1-RA, respectively. Among these, 1208 patients for each group were included in the matched cohort. As compared with SU, those treated with DPP-4i, SGLT2i and GLP-1-RA were associated to a risk reduction for hospitalization for major adverse cardiovascular events (MACE) of 22% (95% CI 3% to 37%), 29% (95% CI 12% to 44%) and 41% (95% CI 26% to 53%), respectively. The ICER values indicated an average gain of €96.2 and €75.7 each month free from MACE for patients on DPP-4i and SGLT2i, respectively.

CONCLUSIONS:

Newer diabetes drugs are more effective and cost-effective second-line options for the treatment of type 2 diabetes than SUs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Compuestos de Sulfonilurea / Análisis Costo-Beneficio / Diabetes Mellitus Tipo 2 / Inhibidores de la Dipeptidil-Peptidasa IV / Hipoglucemiantes Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMJ Open Diabetes Res Care Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Compuestos de Sulfonilurea / Análisis Costo-Beneficio / Diabetes Mellitus Tipo 2 / Inhibidores de la Dipeptidil-Peptidasa IV / Hipoglucemiantes Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMJ Open Diabetes Res Care Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido