Persistence and adherence to sodium-glucose co-transporter 2 inhibitor monotherapy among patients with type 2 diabetes mellitus: a retrospective study based on a Japanese claims database

TL;DR

This study analyzed how patients with type 2 diabetes in Japan stick to SGLT2i medication and found factors that help them continue treatment.

Contribution

The study identifies specific patient characteristics linked to better persistence and adherence to SGLT2i monotherapy in Japan.

Findings

61.0% of patients persisted with SGLT2i monotherapy after one year.

58.3% of patients adhered to treatment with a mean PDC of 71.2%.

Older age and comorbidities like hypertension and dyslipidemia were linked to lower risk of discontinuation or poor adherence.

Abstract

The aims of this retrospective study were to examine persistence/adherence rates to sodium-glucose co-transporter 2 inhibitors (SGLT2i) monotherapy in patients with type 2 diabetes (T2DM) and identify factor(s) affecting persistence/adherence. Claims data on patients with T2DM newly using SGLT2i monotherapy from the JMDC database between October 2017 and September 2020 were analyzed. Persistence without a 90-day gap was calculated from the index date until the time of discontinuation of SGLT2i in a 1-year follow-up. Adherence was calculated using the proportion of days covered (PDC). Baseline characteristics were examined as potential factors affecting persistence/adherence using a multivariate logistic method. The present study identified 2172 new users of SGLT2i monotherapy. The persistence rate to SGLT2i after 365 days was 61.0%. Mean PDC was 71.2%, and 58.3% of patients adhered to treatment. A multivariate logistic regression analysis showed that an older age, hypertension, dyslipidemia, and hyperuricemia were associated with a lower risk of the discontinuation of SGLT2i monotherapy, while an older age, hypertension, dyslipidemia, and hyperuricemia were associated with a lower risk of poor adherence. The present study identified several factors that reduced the risk of discontinuation/poor adherence to SGLT2i monotherapy in patients with T2DM. An older age, hypertension, dyslipidemia, and hyperuricemia were common factors for a lower risk of discontinuation/poor adherence.

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