PCV10 Anti-Glycemic Medication Treatment Patterns Among Type II Diabetes Mellitus Patients Initiating Lipid-Altering Regimens

Abstract

ANTI-GLYCEMIC MEDICATION TREATMENT PATTERNS AMONG TYPE II DIABETES MELLITUS PATIENTS INITIATING LIPID-ALTERING REGIMENS Simko RJ1, Koselleck D2, Quimbo RA3, Cziraky MJ4, Toth PP5 1Abbott Laboratories, Abbott Park, IL, USA, 2Abbott Labs, Abbott park, IL, USA, 3HealthCore, Wilmington, DE, USA, 4HealthCore, Inc., Wilmington, DE, USA, 5Sterling Rock Falls Clinic, Ltd.; University of Illinois School of Medicine, Sterling, IL, USA OBJECTIVES: To evaluate changes in anti-glycemic treatment patterns in patients newly augmenting statin therapy with niacin extended-release (NER S), relative to patients initiating alternative lipid regimens. METHODS: An observational cohort study was conducted using integrated administrative claims and laboratory result data within the HealthCore Integrated Research Database. T2DM patients aged 18 to 64 initiating statin-augmenting therapy (NER S, ezetimibe (EZE S), or fenofibrate (FFB S)) or statin monotherapy (SM) between 1/1/2005-11/30/2008 (index date) were included. Patients with 12 months of pre-index eligibility and 1 laboratory result for hemoglobin A1c (HbA1c) within the 12-month period were included. The utilization and average daily dose (ADD) of anti-glycemic medications during the 12-month pre-index and follow-up period were compared between cohorts. RESULTS: A total of 42,250 patients were identified: 2,041 NER S, 6,915 EZE S, 3,095 FFB S, and 30,199 SM. Compared to each cohort, NER S patients were more likely to be male (P 0.0001), and have higher prevalence of preexisting ischemic heart conditions (P 0.0001). NER S patients had lowest preindex total cholesterol (174.3 55.2; P 0.0001), HDL-C (37.2 10.1; P 0.0001), second lowest LDL-C (93.7 38.4), and second highest TG (245.3 307.0) prior to the index date. Among oral anti-glycemic therapies, NER S patients were observed to have the largest decrease in ADD (mg/day) for biguanides (metformin: -155.9 788.0; P 0.0001), sulfonylureas (glimepiride: -0.1 1.9; P 0.0053; glipizide: -0.8 20.8; P .0001), TZD’s (pioglitizone: -0.8 8.2; P 0.0210), and incretin mimetic agents (exenatide: -0.1 3.5; P 0.0012) from pre-index to follow-up. Furthermore, NER S patients had the smallest increase in ADD of DPP-4’s (sitagliptin: 0.3 17.6; P 0.0067). CONCLUSIONS: Despite studies indicating the potential for NER to antagonize glycemic control among T2DM patients, patients initiating NER S were observed to have decreased utilization and average daily dose of anti-glycemic medications, relative to alternative treatment regimens.