Determinants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti-diabetic drugs

Abstract Background The patterns and determinants of saxagliptin use among patients with type 2 diabetes mellitus (T2DM) are unknown in real-world settings. We compared the characteristics of T2DM patients who were new initiators of saxagliptin to those who were new initiators of non-dipeptidyl pept...

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Main Authors: M Elle Saine, Dean M Carbonari, Craig W Newcomb, Melissa S Nezamzadeh, Kevin Haynes, Jason A Roy, Serena Cardillo, Sean Hennessy, Crystal N Holick, Daina B Esposito, Arlene M Gallagher, Harshvinder Bhullar, Brian L Strom, Vincent Lo Re
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Language:English
Published: BMC 2015-04-01
Series:BMC Pharmacology and Toxicology
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Online Access:https://doi.org/10.1186/s40360-015-0007-z
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author M Elle Saine
Dean M Carbonari
Craig W Newcomb
Melissa S Nezamzadeh
Kevin Haynes
Jason A Roy
Serena Cardillo
Sean Hennessy
Crystal N Holick
Daina B Esposito
Arlene M Gallagher
Harshvinder Bhullar
Brian L Strom
Vincent Lo Re
author_facet M Elle Saine
Dean M Carbonari
Craig W Newcomb
Melissa S Nezamzadeh
Kevin Haynes
Jason A Roy
Serena Cardillo
Sean Hennessy
Crystal N Holick
Daina B Esposito
Arlene M Gallagher
Harshvinder Bhullar
Brian L Strom
Vincent Lo Re
author_sort M Elle Saine
collection DOAJ
description Abstract Background The patterns and determinants of saxagliptin use among patients with type 2 diabetes mellitus (T2DM) are unknown in real-world settings. We compared the characteristics of T2DM patients who were new initiators of saxagliptin to those who were new initiators of non-dipeptidyl peptidase-4 (DPP-4) inhibitor oral anti-diabetic drugs (OADs) and identified factors associated with saxagliptin use. Methods We conducted a cross-sectional study within the Clinical Practice Research Datalink (CPRD), The Health Improvement Network (THIN), US Medicare, and the HealthCore Integrated Research Database (HIRDSM) across the first 36 months of saxagliptin availability (29 months for US Medicare). Patients were included if they were: 1) ≥18 years old, 2) newly prescribed saxagliptin or a non-DPP-4 inhibitor OAD, and 3) enrolled in their respective database for 180 days. For each saxagliptin initiator, we randomly selected up to ten non-DPP-4 inhibitor OAD initiators matched on age, sex, and geographic region. Conditional logistic regression was used to identify determinants of saxagliptin use. Results We identified 64,079 saxagliptin initiators (CPRD: 1,962; THIN: 2,084; US Medicare: 51,976; HIRDSM: 8,057) and 610,660 non-DPP-4 inhibitor OAD initiators (CPRD: 19,484; THIN: 19,936; US Medicare: 493,432; HIRDSM: 77,808). Across all four data sources, prior OAD use, hypertension, and hyperlipidemia were associated with saxagliptin use. Saxagliptin initiation was also associated with hemoglobin A1c results >8% within the UK data sources, and a greater number of hemoglobin A1c measurements in the US data sources. Conclusions In these UK and US data sources, initiation of saxagliptin was associated with prior poor glycemic control, prior OAD use, and diagnoses of hypertension and hyperlipidemia. Trial registration ClinicalTrials.gov identifiers NCT01086280 , NCT01086293 , NCT01086319 , NCT01086306 , and NCT01377935
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spelling doaj-art-2d1f567b51f548658000072312263efa2025-08-20T03:08:44ZengBMCBMC Pharmacology and Toxicology2050-65112015-04-0116111610.1186/s40360-015-0007-zDeterminants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti-diabetic drugsM Elle Saine0Dean M Carbonari1Craig W Newcomb2Melissa S Nezamzadeh3Kevin Haynes4Jason A Roy5Serena Cardillo6Sean Hennessy7Crystal N Holick8Daina B Esposito9Arlene M Gallagher10Harshvinder Bhullar11Brian L Strom12Vincent Lo Re13Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of PennsylvaniaDepartment of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of PennsylvaniaDepartment of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of PennsylvaniaDepartment of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of PennsylvaniaDepartment of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of PennsylvaniaDepartment of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of PennsylvaniaDepartment of Medicine, Perelman School of Medicine at the University of PennsylvaniaDepartment of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of PennsylvaniaHealthCore, IncHealthCore, IncClinical Practice Research Datalink, Medicines and Healthcare Products Regulatory AgencyCegedim Strategic Data Medical ResearchDepartment of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of PennsylvaniaDepartment of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of PennsylvaniaAbstract Background The patterns and determinants of saxagliptin use among patients with type 2 diabetes mellitus (T2DM) are unknown in real-world settings. We compared the characteristics of T2DM patients who were new initiators of saxagliptin to those who were new initiators of non-dipeptidyl peptidase-4 (DPP-4) inhibitor oral anti-diabetic drugs (OADs) and identified factors associated with saxagliptin use. Methods We conducted a cross-sectional study within the Clinical Practice Research Datalink (CPRD), The Health Improvement Network (THIN), US Medicare, and the HealthCore Integrated Research Database (HIRDSM) across the first 36 months of saxagliptin availability (29 months for US Medicare). Patients were included if they were: 1) ≥18 years old, 2) newly prescribed saxagliptin or a non-DPP-4 inhibitor OAD, and 3) enrolled in their respective database for 180 days. For each saxagliptin initiator, we randomly selected up to ten non-DPP-4 inhibitor OAD initiators matched on age, sex, and geographic region. Conditional logistic regression was used to identify determinants of saxagliptin use. Results We identified 64,079 saxagliptin initiators (CPRD: 1,962; THIN: 2,084; US Medicare: 51,976; HIRDSM: 8,057) and 610,660 non-DPP-4 inhibitor OAD initiators (CPRD: 19,484; THIN: 19,936; US Medicare: 493,432; HIRDSM: 77,808). Across all four data sources, prior OAD use, hypertension, and hyperlipidemia were associated with saxagliptin use. Saxagliptin initiation was also associated with hemoglobin A1c results >8% within the UK data sources, and a greater number of hemoglobin A1c measurements in the US data sources. Conclusions In these UK and US data sources, initiation of saxagliptin was associated with prior poor glycemic control, prior OAD use, and diagnoses of hypertension and hyperlipidemia. Trial registration ClinicalTrials.gov identifiers NCT01086280 , NCT01086293 , NCT01086319 , NCT01086306 , and NCT01377935https://doi.org/10.1186/s40360-015-0007-zDiabetes mellitusSaxagliptinDipeptidyl peptidase IV inhibitorPharmacoepidemiology
spellingShingle M Elle Saine
Dean M Carbonari
Craig W Newcomb
Melissa S Nezamzadeh
Kevin Haynes
Jason A Roy
Serena Cardillo
Sean Hennessy
Crystal N Holick
Daina B Esposito
Arlene M Gallagher
Harshvinder Bhullar
Brian L Strom
Vincent Lo Re
Determinants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti-diabetic drugs
BMC Pharmacology and Toxicology
Diabetes mellitus
Saxagliptin
Dipeptidyl peptidase IV inhibitor
Pharmacoepidemiology
title Determinants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti-diabetic drugs
title_full Determinants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti-diabetic drugs
title_fullStr Determinants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti-diabetic drugs
title_full_unstemmed Determinants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti-diabetic drugs
title_short Determinants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti-diabetic drugs
title_sort determinants of saxagliptin use among patients with type 2 diabetes mellitus treated with oral anti diabetic drugs
topic Diabetes mellitus
Saxagliptin
Dipeptidyl peptidase IV inhibitor
Pharmacoepidemiology
url https://doi.org/10.1186/s40360-015-0007-z
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