977-P: Trends in First-Line Glucose-Lowering Drug Use in Adults with Type 2 Diabetes in Light of Emerging Evidence for SGLT2i and GLP-1RA

Abstract

Recent utilization trends and predictors of first-line antidiabetic treatment in patients with type 2 diabetes (T2D) remain unexplored. Using Medicare and a large U.S. health insurance database of commercially-insured patients (Clinformatics), we identified adult patients with T2D who initiated first-line antidiabetic treatment during 2013-2019. Quarterly utilization trends were plotted overall and by cardiovascular disease (CVD). We estimated predictors of first-line antidiabetic treatment, using metformin, the recommended first-line treatment for T2D, as the common referent. Metformin was the most frequently initiated medication (80.6% in Medicare and 83.1% in Clinformatics) (Figure). Sulfonylureas were used by 8.7% in Medicare and by 4.7% in Clinformatics. Both populations had low use of SGLT-2 inhibitors (SGLT-2i, 0.8% [Medicare] and 1.7% [Clinformatics]) and GLP-1 receptor agonists (GLP-1RA, 1.0% [Medicare] and 3.5% [Clinformatics]), with increasing trends over time (P Among adult patients with T2D, metformin was the most frequent first-line treatment. The use of SGLT-2i and GLP-1RA remained low, though with a greater use among patients with CVD. Disclosure H. Shin: None. S. Schneeweiss: Other Relationship; Self; Aetion. R. Glynn: Research Support; Self; AstraZeneca, Kowa Research Institute, Inc., Novartis AG, Pfizer Inc. E. Patorno: Research Support; Self; Boehringer Ingelheim International GmbH, National Institutes of Health. Funding Brigham and Women’s Hospital; National Institute on Aging (K08AG055670 to E.P.)