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Real-world adherence, persistence, and in-class switching during use of dipeptidyl peptidase-4 inhibitors: a systematic review and meta-analysis involving 594,138 patients with type 2 diabetes.
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- Author(s): Ogundipe O;Ogundipe O; Mazidi M; Mazidi M; Chin KL; Chin KL; Chin KL; Gor D; Gor D; McGovern A; McGovern A; McGovern A; Sahle BW; Sahle BW; Jermendy G; Jermendy G; Korhonen MJ; Korhonen MJ; Appiah B; Appiah B; Appiah B; Ademi Z; Ademi Z; De Bruin ML; De Bruin ML; Liew D; Liew D; Ofori-Asenso R; Ofori-Asenso R; Ofori-Asenso R
- Source:
Acta diabetologica [Acta Diabetol] 2021 Jan; Vol. 58 (1), pp. 39-46. Date of Electronic Publication: 2020 Aug 18.- Publication Type:
Journal Article; Meta-Analysis; Systematic Review- Language:
English - Source:
- Additional Information
- Source: Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9200299 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-5233 (Electronic) Linking ISSN: 09405429 NLM ISO Abbreviation: Acta Diabetol Subsets: MEDLINE
- Publication Information: Publication: Berlin : Springer Verlag
Original Publication: Berlin : Springer International, c1991- - Subject Terms: Diabetes Mellitus, Type 2/*drug therapy ; Diabetes Mellitus, Type 2/*epidemiology ; Dipeptidyl-Peptidase IV Inhibitors/*therapeutic use ; Drug Substitution/*statistics & numerical data ; Medication Adherence/*statistics & numerical data; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Humans ; Hypoglycemic Agents/therapeutic use ; Male ; Middle Aged ; Treatment Outcome ; Withholding Treatment/statistics & numerical data ; Young Adult
- Abstract: Aims: Medication adherence and persistence are important determinants of treatment success in type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis evaluated the real-world adherence, persistence, and in-class switching among patients with T2DM prescribed dipeptidyl peptidase-4 (DPP4) inhibitors.
Methods: MEDLINE, EMBASE, Cochrane Library, PsychINFO, and CINAHL were searched for relevant observational studies published in the English language up to 20 December 2019. This was supplemented by manual screening of the references of included papers. Random-effects meta-analysis was performed.
Results: Thirty-four cohort studies involving 594,138 patients with T2DM prescribed DPP4 inhibitors from ten countries were included. The pooled proportion adherent (proportion of days covered (PDC) or medication possession ratio (MPR) ≥ 0.80) was 56.9% (95% confidence interval [CI] 49.3-64.4) at one year and 44.2% (95% CI 36.4-52.1) at two years. The proportion persistent with treatment decreased from 75.6% (95% CI 71.5-79.5) at six months to 52.8% (95% CI 51.6-59.8) at two years. No significant differences in adherence and persistence were observed between individual DPP4 inhibitors. At one year, just 3.2% (95% CI 3.1-3.3) of patients switched from one DPP4 inhibitor to another. Switching from saxagliptin and alogliptin to others was commonest.
Conclusions: Adherence to and persistence with DPP4 inhibitors is suboptimal but similar across all medications within the class. While in-class switching is uncommon, saxagliptin and alogliptin are the DPP4 inhibitors most commonly switched. Interventions to improve treatment adherence and persistence among patients with T2DM prescribed DPP4 inhibitors may be warranted. - References: Davies MJ, D'Alessio DA, Fradkin J et al (2018) A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2018(41):2669–2701. (PMID: 10.2337/dci18-0033)
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Ofori-Asenso R, Sahle B, Chin KL et al (2020) Poor adherence and persistence to sodium glucose co-transporter 2 inhibitors in real world settings: evidence from a systematic review and meta-analysis. Diabetes Metab Res Rev 24:e3350. https://doi.org/10.1002/dmrr.3350. (PMID: 10.1002/dmrr.3350)
Jermendy G, Kiss Z, Rokszin R et al (2018) Persistence to treatment with novel antidiabetic drugs (dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter-2 inhibitors, and glucagon-like peptide-1 receptor agonists) in people with type 2 diabetes: a nationwide cohort study. Diabetes Ther 9(5):2133–2141. (PMID: 10.1007/s13300-018-0483-4) - Contributed Indexing: Keywords: Adherence; DPP4 inhibitors; Dipeptidyl peptidase-4 inhibitors; Discontinuation; Gliptins; Hypoglycemic agents; Persistence; Switching
- Accession Number: 0 (Dipeptidyl-Peptidase IV Inhibitors)
0 (Hypoglycemic Agents) - Publication Date: Date Created: 20200819 Date Completed: 20210305 Latest Revision: 20210305
- Publication Date: 20231215
- Accession Number: 10.1007/s00592-020-01590-w
- Accession Number: 32809070
- Source:
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