This article is more than 5 years old. Information may no longer be current.
Adherence high with sitagliptin plus metformin
Click Here to Manage Email Alerts
Compared with adults on sulfonylurea plus metformin, adults prescribed sitagliptin plus metformin had significantly better adherence and persistence, study data show.
“In this observational study conducted within a U.S. administrative claims database, we found that in adults with diabetes, treatment adherence and persistence for sitagliptin was higher than that for sulfonylureas,” Swapnil N. Rajpathak, MD, MPH, DrPH, executive director of outcomes research in the Center for Observational and Real-World Evidence at Merck, told Endocrine Today.
Rajpathak and colleagues evaluated data from a claims database on adults with type 2 diabetes who were prescribed a sulfonylurea (n = 14,807) or sitagliptin (Januvia, Merck; n = 14,807) added to ongoing metformin. Participants were continually enrolled for 12 months before the add-on to metformin monotherapy (index date) and had metformin coverage for at least 45 days but no more than 90 days before the index date.
The sitagliptin plus metformin group had significantly higher 1-year mean proportion of days covered compared with the sulfonylurea plus metformin group. More of the sitagliptin plus metformin group was adherent (59.1%) compared with the sulfonylurea plus metformin group (55.9%) at 1 year (P < .001); the same was true for 2 years (sitagliptin plus metformin, 52.6% vs. sulfonylurea plus metformin, 49.9%; P = .007). However, rates of adherence did not significantly differ between the two groups at 3 years. Compared with the sulfonylurea plus metformin group, more of the sitagliptin plus metformin group continued use at 1, 2 and 3 years (P < .05 for all).
Discontinuation was less likely among the sitagliptin plus metformin group (P < .001), and out-of-pocket expense increases were related to an increased risk for discontinuing the index medication (P < .001).
“Suboptimal medication adherence can be an issue in the management of chronic diseases, such as diabetes,” Rajpathak told Endocrine Today. “Different drug classes have different profiles, which, in addition to individual patient factors, may also impact adherence to treatment. Therefore, these findings may be relevant when choosing among different therapies for diabetes. The findings of the study should be replicated in different populations and different data sources. Future research could also evaluate the potential reasons and clinical/economic consequences of differential adherence rates in these drug classes.” – by Amber Cox
For more information:
Swapnil N. Rajpathak, MD, MPH, DrPH, can be reached at swapnil.rajpathak@merck.com.
Disclosure: Rajpathak reports being an employee of Merck.
Click Here to Manage Email Alerts