Discontinuation of SGLT-2i and GLP-1RA among persons with Type 2 diabetes and atherosclerotic cardiovascular disease treated in US cardiology clinics

IF 3.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS American heart journal Pub Date : 2024-12-21 DOI:10.1016/j.ahj.2024.12.006

Adam J. Nelson MBBS, MPH, MBA, PhD , Lisa A. Kaltenbach MS , Darren K. McGuire MD, MHS , Monica Levya RCIS, MHA , Hussein R. Al-Khalidi PhD , Laura Webb BS, CCRP , Renato D. Lopes MD, PhD , Rodica Pop-Busui MD, PhD , Matthew A. Cavender MD, MPH , Vanita R. Aroda MD , Melissa L. Magwire MSN, RN , Caroline R. Richardson MD , Ildiko Lingvay MD, MPH, MSCS , Julienne K. Kirk BS, PharmD , Ambarish Pandey MD , Tanya Gaynor MPAS, PA-C , Jonathan Pak PharmD, MBA , Alana Washington PharmD, MBA , Cagri Senyucel MD, PhD , Jennifer B. Green MD , Neha J. Pagidipati MD, MPH

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Abstract

Background

SGLT-2i and GLP-1RA are recommended for persons with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD); for those prescribed, little is known about reasons for discontinuation.

Methods

From the COORDINATE-Diabetes randomized trial database, the frequency and reasons for discontinuation of SGLT2i or GLP-1RA were analyzed.

Results

1045 participants were enrolled 7/2019 to 5/2022; 290 (27.8%) were prescribed SGLT-2i of whom 67 (23.1%) discontinued; and 118 (11.3%) were prescribed GLP-1RA of whom 38 (32.2%) discontinued. Race, age and sex did not differ among those discontinuing either class. Medicare was more common among those discontinuing vs persisting with SGLT-2i (71.4 vs. 58.1%; p=0.058) and GLP-1RA (71.1 vs. 49.4%); p=0.027). Cost, side effects, and patient choice were common reasons for discontinuation.

Conclusion

Up to one-third of participants discontinued either an SGLT-2i or GLP-1RA within 12 months of initiating. Efforts to address modifiable contributors to discontinuation are required.

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在美国心脏病诊所治疗的2型糖尿病和动脉粥样硬化性心血管疾病患者中停用SGLT-2i和GLP-1RA

SGLT-2i和GLP-1RA推荐用于2型糖尿病和动脉粥样硬化性心血管疾病（ASCVD）患者，但在临床实践中应用不足。COORDINATE-Diabetes随机临床试验评估了一项多方面的干预措施，以增加循证疗法的使用，降低糖尿病和动脉粥样硬化性心血管疾病参与者的心血管风险。本分析报告了SGLT-2i和GLP-1RA在随访中的停药率，并总结了这些决定背后的临床报告原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American heart journal 医学-心血管系统

CiteScore

8.20

自引率

2.10%

发文量

214

审稿时长

38 days

期刊介绍： The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.