1. Adherence to and persistence with oral antidiabetic medication were evaluated in a sample of 238,372 patients with type 2 diabetes initiating a dipeptidyl peptidase-4 inhibitor (DPP-4i), a sulfonylurea (SU), or a thiazolidinediones (TZD) in a retrospective cohort analysis using administrative health care claims.
Initiation of a DPP-4i was associated with greater odds of being adherent over a one-year follow-up period than initiation of an SU (odds ratio [OR] = 1.678, P <0.001) or TZD (OR = 1.605, P <0.001), and within the DPP-4i medication class, initiation of saxagliptin was associated with better adherence than initiation of sitagliptin (OR = 1.213, P <0.001).
Compared with initiation of a DPP-4i, initiation of an SU (hazard ratio [HR] = 1.390, P <0.001) or a TZD (HR = 1.402, P <0.001) was associated with greater risk of discontinuation of therapy over a one-year follow-up period, as was initiation of sitagliptin compared with saxagliptin (HR = 1.159, P <0.001).
Results were consistent over a two-year follow-up period and within subgroups of patients who initiated monotherapy and who did not fill their first prescription via mail-order pharmacy.
These findings support the use of DPP-4i medications, specifically saxagliptin, in treating type 2 diabetes, as adherence and persistence are important to experiencing optimal clinical outcomes.
This summary slide represents the opinions of the authors. Sponsorship for this study was funded by Bristol-Myers Squibb and AstraZeneca. For a full list of acknowledgments and conflicts of interest for all authors of this article, please see the full text online. Copyright © The Authors Creative Commons Attribution Noncommercial License (CC BY-NC).
Farr AM, et al. Adv Ther