Persistence ‘strongly influenced’ by medication class for type 2
Persistence is strongly influenced by medication class and should be considered when initiating treatments for people with type 2 diabetes, according to research.
A study has been carried out to explore which oral therapies have the best persistence in controlling the condition. The research team compared different medications with a person’s persistence and how they responded to the drugs.
New prescriptions for oral diabetes medication in people with type 2 diabetes were used for the trial and the median persistence across each class as recorded. They also also compared non-persistence (defined as a prescription gap of ≥ 90 days) between classes, adjusting for confounders, using Cox regression.
The confounders included were age, gender, ethnicity, socioeconomic status, alcohol use, smoking status, glycaemic control, diabetes duration, diabetes complications, comorbidities, and anumber of previous and concurrent diabetes medications.
Of the 60,327 adults with type 2 diabetes who participated in the study, 42,810 (70.9 per cent) were using one or more oral medication. Metformin had the longest median persistence (3.04 years; 95 per cent CI 2.94–3.12). The adjusted hazard ratios for non-persistence compared with metformin were: sulfonylureas HR 1.20 (1.16–1.24), DPP-4 inhibitors HR 1.43 (1.38–1.49), thiazolidinediones HR 1.71 (95% CI 1.64–1.77), SGLT2 inhibitors HR 1.04 (0.93–1.17), meglitinides HR 2.25 (1.97–2.58), and alpha-glucosidase inhibitors HR 2.45 (1.98–3.02).
The analysis of SGLT2 inhibitors was limited by the short duration of follow-up for this new class. Other factors associated with reduced medication persistence were female gender, younger age, and non-white ethnicity.
Lead researcher Dr Andrew McGovern, a clinical researcher from the University of Surrey, said: “Persistence is strongly influenced by medication class and should be considered when initiating treatments.”
To read the study, click here.