Transitional changes in medication‐initiator cohort profiles in persons with chronic kidney disease and type 2 diabetes—A hospital‐based cohort study in Japan

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: April 21, 2025

Abstract Aims To describe temporal changes in the characteristics of medication‐initiator cohorts persons with chronic kidney disease (CKD) and type 2 diabetes (T2D). Materials Methods Adults CKD T2D initiating sodium‐glucose cotransporter‐2 inhibitors (SGLT‐2i) or glucagon‐like peptide‐1 receptor agonists (GLP‐1RA) were identified Japan Chronic Kidney Disease Database Extension each two study periods (Period I: 1 January 2014–30 June 2021; Period II: July 2021–31 December 2022). For cohort, baseline standard mean differences (SMD) between I II assessed. Results During II, 1157 1122 SGLT‐2i, 329 369 GLP‐1RA new users identified, respectively. All four had similar age, sex comorbidity patterns, a age spanning 66.1–69.5 years 60%–70% being male. More than 80% hypertension 60% congestive heart failure. In SGLT‐2i cohorts, we observed decrease prior metformin dipeptidyl peptidase‐4 inhibitor use (SMD ≥0.5 <0.8), an increase number no medications other insulin >0.8). there was medium using insulin. Conclusions With introduction treatments emerging evidence supporting cardio‐renal protective effects people T2D, notable treatment cohort characteristics. These findings suggest earlier course T2D.

Language: Английский

Real world evidence of insulin and biosimilar insulin therapy—Opportunities to improve adherence, outcomes and cost‐effectiveness

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: April 15, 2025

Abstract Insulin has been discovered for more than a century; however, its benefits to people with diabetes are yet be fully realized due barriers related access, quality of care and costs. therapy remains the cornerstone management. The multicausality subtypes calls comprehensive phenotyping use biomarkers ensure timely insulin achieve early glycaemic control long‐term benefits. Biosimilar insulins biologic products that closely resemble originator without significant differences in safety or efficacy. lower investment costs needed research development make biosimilar affordable improve access. While efficacy is proven controlled settings, real world evidence (RWE) from data (RWD) plays crucial role assessing safety, efficacy, cost‐effectiveness, adherence impacts different products, including biosimilars, on clinical outcomes. In this narrative review, we summarized trends patterns utilization practice across regions. We reviewed RWE cost‐effectiveness insulin, as well therapeutic inertia non‐adherence therapy. also highlighted enablers persistence, along potential solutions promote technologies optimizing diabetes. During our extensive literature identified gaps usage practice. advocate implementing register designed fit‐for‐purpose, managed by trained doctor–nurse team system support, generate RWE. By setting up registers structured collection, can high integrative analysis electronic health records (EHR) claims evaluate other programmes outcomes, life healthcare inform policies. Plain Language Summary Diabetes affects approximately 10.5% global population vital treatment was century ago, although care, Real‐world real‐world to, publication, authors provided detailed review major gaps. explained methodology, utility, limitations generating based sources such registers, effectiveness safety. proposed implementation purpose‐built support. These high‐quality integrated evaluation interventions, life, policy. Based these premises available data, products. They like non‐adherence, discussed programs

Language: Английский