03 Oct 2022 Characteristics of new users of recent antidiabetic drugs in Canada and the United Kingdom
Vanessa C. Brunetti, Audray St-Jean, Sophie Dell’Aniello, Anat Fisher, Oriana H. Y. Yu, Shawn C. Bugden, Jean-Marc Daigle, Nianping Hu, Silvia Alessi-Severini, Baiju R. Shah, Paul E. Ronksley, Lisa M. Lix, Pierre Ernst, Kristian B. Filion for the Canadian Network for Observational Drug Effect Studies (CNODES) Investigators
Characteristics of new users of recent antidiabetic drugs in Canada and the United Kingdom
BMC Endocrine Disorders volume 22, Article number: 241 (2022) https://doi.org/10.1186/s12902-022-01140-1
Abstract
Background
Characteristics of patients using newer 2nd and 3rd line antidiabetic drugs in a real-world setting are poorly understood. We described the characteristics of new users of sodium-glucose co-transporter-2 inhibitors (SGLT-2i), dipeptidyl peptidase-4 inhibitors (DPP-4i), and glucagon-like peptide-1 receptor agonists (GLP-1 RA) in Canada and the United Kingdom (UK) between 2016 and 2018.
Methods
We conducted a multi-database cohort study using administrative health databases from 7 Canadian provinces and the UK Clinical Practice Research Datalink. We assembled a base cohort of antidiabetic drug users between 2006 and 2018, from which we constructed 3 cohorts of new users of SGLT-2i, DPP-4i, and GLP-1 RA between 2016 and 2018.
Results
Our cohorts included 194,070 new users of DPP-4i, 166,722 new users of SGLT-2i, and 27,719 new users of GLP-1 RA. New users of GLP-1 RA were more likely to be younger (mean ± SD: 56.7 ± 12.2 years) than new users of DPP-4i (67.8 ± 12.3 years) or SGLT-2i (64.4 ± 11.1 years). In Canada, new users of DPP-4i were more likely to have a history of coronary artery disease (22%) than new users of SGLT-2i (20%) or GLP-1 RA (15%).
Conclusion
Although SGLT-2i, DPP-4i, and GLP-1 RAs are recommended as 2nd or 3rd line therapy for type 2 diabetes, important differences exist in the characteristics of users of these drugs. Contrary to existing guidelines, new users of DPP-4i had a higher prevalence of cardiovascular disease at baseline than new users of SGLT2i or GLP-1RA.
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