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ComparativeEffectiveness ofDPP-4 InhibitorsVersus Sulfonylureafor the Treatment ofType 2 Diabetes inRoutine ClinicalPractice Gian Paolo FadiniDaniele BottigliengoFederica D’Angelo2018 год

Comparative Effectiveness of DPP-4 Inhibitors Versus Sulfonylurea for the Treatment of Type 2 Diabetes in Routine Clinical Practice: A Retrospective Multicenter Real-World Study
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Аннотация: DPP-4 inhibitors (DPP4i) and sulfonylureas are popular second-line therapies for type 2 diabetes (T2D), but there is a paucity of real-world studies comparing their effectiveness in routine clinical practice. This was a multicenter retrospective study on diabetes outpatient clinics comparing the effectiveness of DPP4i versus gliclazide extended release. The primary endpoint was change from baseline in HbA1c. Secondary endpoints were changes in fasting plasma glucose, body weight, and systolic blood pressure. Automated software extracted data from the same clinical electronic chart system at all centers. Propensity score matching (PSM) was used to generate comparable cohorts to perform outcome analysis. We included data on 2410 patients starting DPP4i and 1590 patients starting gliclazide (mainly 30–60 mg/day). At baseline, the two groups differed in disease duration, body weight, blood pressure, HbA1c, fasting glucose, HDL cholesterol, triglycerides, liver enzymes, eGFR, prevalence of microangiopathy, and use of metformin. Among DPP4i molecules, no difference in glycemic effectiveness was detected. In matched cohorts (n = 1316/group), patients starting DPP4i, as compared with patients starting gliclazide, experienced greater reductions in HbA1c (− 0.6% versus − 0.4%; p < 0.001), fasting glucose (− 14.1 mg/dl versus − 8.8 mg/dl; p = 0.007), and body weight (− 0.4 kg versus − 0.1 kg; p = 0.006) after an average 6 months follow-up. DPP4i improved glucose control more than gliclazide, especially in patients who had failed with other glucose-lowering medications or were on basal insulin. This large retrospective real-world study shows that, in routine clinical practice, starting a DPP4i allows better glycemic control than starting low-dose gliclazide. The Italian Diabetes Society, with external support from AstraZeneca.
Год издания: 2018
Авторы: Gian Paolo Fadini, Daniele Bottigliengo, Federica D’Angelo, Franco Cavalot, Antonio Carlo Bossi, Giancarlo Zatti, Ileana Baldi, Angelo Avogaro, Agostino Consoli, Gloria Formoso, Giovanni Grossi, Achiropita Pucci, Giorgio Sesti, Francesco Andreozzi, Giuseppe Capobianco, A Gatti, Riccardo C. Bonadonna, Ivana Zavaroni, Alessandra Dei, Giuseppe Felace, Patrizia Li Volsi, Raffaella Buzzetti, Gaetano Leto, Gian Pio Sorice, Paola D’Angelo, Susanna Morano, Antonio Carlo Bossi, Edoardo Duratorre, Ivano Franzetti, Paola Silvia Morpurgo, Emanuela Orsi, Fabrizio Querci, Massimo Boemi, Federica D’Angelo, Massimiliano Petrelli, Gianluca Aimaretti, Ioannis Karamouzis, Franco Cavalot, G Saglietti, Giuliana Cazzetta, Silvestre Cervone, Eleonora Devangelio, Olga Lamacchia, Salvatore Arena, A. Di Benedetto, Lucia Frittitta, Carla Giordano, Salvatore Piro, Manfredi Rizzo, Roberta Chianetta, Carlo Mannina, Roberto Anichini, Giuseppe Penno, Anna Solini, Bruno Fattor, Enzo Bonora, M. Cigolini, Annunziata Lapolla, Nino Cristiano Chilelli, Maurizio Poli, Natalino Simioni, Vera Frison, Carmela Vinci
Издательство: Adis, Springer Healthcare
Источник: Diabetes Therapy
Ключевые слова: Diabetes Treatment and Management, Metabolism, Diabetes, and Cancer, Peptidase Inhibition and Analysis
Другие ссылки: Diabetes Therapy (PDF)
Diabetes Therapy (HTML)
PubMed Central (HTML)
PubMed (HTML)