PMID- 30964362
OWN - NLM
STAT- MEDLINE
DCOM- 20200610
LR  - 20221207
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 35
IP  - 9
DP  - 2019 Sep
TI  - Real-world impact of glycated hemoglobin reduction on treatment intensification 
      and glycated hemoglobin goal attainment in type 2 diabetes mellitus patients 
      initiated on a sodium glucose co-transporter 2 (SGLT2) inhibitor (SGLT2i).
PG  - 1607-1614
LID - 10.1080/03007995.2019.1605160 [doi]
AB  - Objective: To evaluate the impact of a 0.2% reduction in glycated hemoglobin 
      (HbA1c) on treatment intensification, poor HbA1c control and HbA1c goal 
      attainment in patients with type 2 diabetes mellitus (T2DM) initiated on a sodium 
      glucose co-transporter 2 (SGLT2) inhibitor (SGLT2i).Methods: IQVIATM Health Plan 
      Claims Data - US and IQVIATM Ambulatory EMR Data - US databases (29 October 
      2012-31 March 2016) were used to identify adults with T2DM initiated on an SGLT2i 
      (index date) who had HbA1c measurements pre- and post-index, and >/=6 months of 
      eligibility pre-index (baseline). HbA1c change was defined as the difference 
      between the first post-index and the last pre-index measurements. Cox regression 
      models were used to assess treatment intensification, poor HbA1c control (i.e. 
      HbA1c > 9%, among patients <9% at baseline) and goal attainment (HbA1c < 7%, <8%; 
      among patients with HbA1c above goal at baseline) adjusting for HbA1c change and 
      baseline characteristics. Patients were observed up to one year after the first 
      HbA1c measurement or end of eligibility. Hazard ratios (HRs) and 95% confidence 
      intervals (CIs) were reported.Results: A total of 938 patients (mean age 54.9, 
      42.5% female, mean HbA1c 8.5%) were selected. Following SGLT2i initiation, each 
      0.2% reduction in HbA1c levels was associated with a decreased risk of treatment 
      intensification (HR [95% CI] = 0.90 [0.86-0.92]), a decreased likelihood of 
      reaching HbA1c > 9% (HR [95% CI] = 0.85 [0.79-0.88]) and higher likelihoods of 
      achieving a treatment goal of HbA1c < 7% (HR [95% CI] = 1.17 [1.12-1.21]) and 
      HbA1c < 8% (HR [95% CI] = 1.08 [1.04-1.10]).Conclusions: In T2DM patients, each 
      HbA1c reduction of 0.2% following the initiation of an SGLT2i was associated with 
      a significant positive impact on treatment intensification and HbA1c goal 
      attainment.
FAU - Brunton, Stephen
AU  - Brunton S
AD  - Primary Care Education Consortium, Charlotte, NC, USA.
FAU - Rozjabek, Heather M
AU  - Rozjabek HM
AD  - Janssen Scientific Affairs LLC, Titusville, NJ, USA.
FAU - Pilon, Dominic
AU  - Pilon D
AD  - Analysis Group Inc., Montreal, QC, Canada.
FAU - Lafeuille, Marie-Helene
AU  - Lafeuille MH
AD  - Analysis Group Inc., Montreal, QC, Canada.
FAU - Kamstra, Rhiannon
AU  - Kamstra R
AD  - Analysis Group Inc., Montreal, QC, Canada.
FAU - Wynant, Willy
AU  - Wynant W
AD  - Analysis Group Inc., Montreal, QC, Canada.
FAU - Bookhart, Brahim K
AU  - Bookhart BK
AD  - Janssen Scientific Affairs LLC, Titusville, NJ, USA.
FAU - Lefebvre, Patrick
AU  - Lefebvre P
AD  - Analysis Group Inc., Montreal, QC, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190503
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Female
MH  - Glycated Hemoglobin/*analysis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Sodium-Glucose Transporter 2 Inhibitors/*therapeutic use
OTO - NOTNLM
OT  - Glycated hemoglobin A
OT  - diabetes mellitus
OT  - sodium-glucose transporter 2 inhibitors
OT  - treatment goal
OT  - treatment intensification
OT  - type 2
EDAT- 2019/04/10 06:00
MHDA- 2020/06/11 06:00
CRDT- 2019/04/10 06:00
PHST- 2019/04/10 06:00 [pubmed]
PHST- 2020/06/11 06:00 [medline]
PHST- 2019/04/10 06:00 [entrez]
AID - 10.1080/03007995.2019.1605160 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2019 Sep;35(9):1607-1614. doi: 10.1080/03007995.2019.1605160. 
      Epub 2019 May 3.