scholarly journals Cardiovascular Risk Associated With Acarbose Versus Metformin as the First-Line Treatment in Patients With Type 2 Diabetes: A Nationwide Cohort Study

2015 ◽  
Vol 100 (3) ◽  
pp. 1121-1129 ◽  
Author(s):  
Chia-Hsuin Chang ◽  
Yi-Cheng Chang ◽  
Jou-Wei Lin ◽  
Shu-Ting Chen ◽  
Lee-Ming Chuang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

scholarly journals Trends in First-Line Glucose-Lowering Drug Use in Adults With Type 2 Diabetes in Light of Emerging Evidence for SGLT-2i and GLP-1RA

2021 ◽  
Author(s):  
HoJin Shin ◽  
Sebastian Schneeweiss ◽  
Robert J. Glynn ◽  
Elisabetta Patorno
Keyword(s):  
Type 2 Diabetes ◽  
Line Treatment ◽  
Medicare Beneficiaries ◽  
First Line ◽  
Adult Type ◽  
Antidiabetic Treatment ◽  
Glucagon Like Peptide 1 ◽  
Lowering Drug ◽  
First Line Treatment

<p>Objective: We evaluated recent utilization trends and predictors of first-line antidiabetic treatment in patients with type 2 diabetes.</p> <p>Research Design and Methods: Using two large U.S. health insurance databases (Clinformatics and Medicare), we identified adult type 2 diabetes patients who initiated antidiabetic treatment from 2013 through 2019. Quarterly trends in use of first-line antidiabetic treatment were plotted overall and stratified by cardiovascular disease (CVD). Multinomial logistic regressions were fit to estimate predictors of first-line antidiabetic treatment, using metformin, the recommended first-line treatment for type 2 diabetes, as the common referent.</p> <p>Results: Metformin was the most frequently initiated medication used by 80.6% of Medicare beneficiaries and 83.1% of commercially insured patients. Sulfonylureas were used by 8.7% (Medicare) and 4.7% (commercial). Both populations had low use of sodium-glucose cotransporter 2 inhibitors (SGLT-2i, 0.8% [Medicare] and 1.7% [commercial]) and glucagon-like peptide 1 receptor agonists (GLP-1RA, 1.0% [Medicare] and 3.5% [commercial]), with increasing trends over time (P < 0.01). Initiators of antidiabetic drugs with established cardiovascular benefits (SGLT-2i and GLP-1RA) were more likely to be younger, and had prevalent CVD or higher socioeconomic status compared with initiators of metformin. </p> <p>Conclusions: Among adult patients with type 2 diabetes, metformin was by far the most frequent first-line treatment. While the use of SGLT-2i and GLP-1RA was low from 2013 through 2019, it increased among patients with CVD.</p>

First-line treatment for type 2 diabetes: is it too early to abandon metformin?

The Lancet ◽  
2020 ◽  
Vol 396 (10264) ◽  
pp. 1705-1707
Author(s):  
Francesco Zaccardi ◽  
Kamlesh Khunti ◽  
Nikolaus Marx ◽  
Melanie J Davies
Keyword(s):  
Type 2 Diabetes ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

scholarly journals Glucocorticoids Are Preferable to Thionamides as First-Line Treatment for Amiodarone-Induced Thyrotoxicosis due to Destructive Thyroiditis: A Matched Retrospective Cohort Study

2009 ◽  
Vol 94 (10) ◽  
pp. 3757-3762 ◽  
Author(s):  
Fausto Bogazzi ◽  
Luca Tomisti ◽  
Giuseppe Rossi ◽  
Enrica Dell'Unto ◽  
Pasquale Pepe ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Line Treatment ◽  
First Line ◽  
University Center ◽  
Cure Time ◽  
First Line Treatment

Context: Type 2 amiodarone-induced thyrotoxicosis (AIT) is a destructive thyroiditis usually responsive to glucocorticoids; however, recent surveys showed that many expert thyroidologists worldwide use thionamides for type 2 AIT patients. Objective: The objective of the study was to compare the effectiveness of methimazole (MMI) or prednisone (GLU) in type 2 AIT patients who had a short cure time according to a published predictive model. Design: This was a matched retrospective cohort study. Setting: The study was conducted at a university center. Patients: Forty-two untreated type 2 AIT patients with a predicted cure time ≤40 d were divided into two groups (MMI and GLU groups). After matching for the predicted cure time, patients in the GLU group were selected in a 1:1 ratio to patients in the MMI group. Intervention: Patients were treated with GLU or MMI for 40 d. Patients still thyrotoxic after 40 d continued glucocorticoids if in the GLU group or were switched to prednisone (MMI-GLU group) if in the MMI group. Main Outcome Measure: Time and rate of cure (healing) at 40 d were measured. Results: Patients still thyrotoxic after 40 d were 23.8 ± 9.3% in the GLU group and 85.7 ± 7.6% in the MMI group (P = 0.000). The GLU and MMI-GLU groups did not significantly differ in the nonhealing rate at 40 d (P = 0.730). When patients in the MMI group were treated with glucocorticoids, 94.1% patients achieved euthyroidism within 40 d. However, the global median cure time (MMI period + prednisone period) was longer (60 d, 95% confidence interval 53.5–66.5 d) in the MMI-GLU group than the GLU group (21 d, 95% confidence interval 15.1–26.9 d). Conclusions: Glucocorticoids are the first-line treatment in type 2 AIT, whereas thionamides play no role in this destructive thyroiditis. Glucocorticoids are the first-line treatment in type 2 amiodarone-induced thyrotoxicosis while thionamides play no role in this destructive thyroiditis.

scholarly journals PDB7 Network Meta-Analysis of Fixed Dose Combination Therapies for the First-Line Treatment of Type 2 Diabetes Mellitus

2012 ◽  
Vol 15 (7) ◽  
pp. A660
Author(s):  
R. Jindal ◽  
J. Gupta ◽  
A. Arora ◽  
M. Kaur ◽  
R. Kumar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Fixed Dose ◽  
Line Treatment ◽  
Combination Therapies ◽  
First Line ◽  
Dose Combination ◽  
First Line Treatment

scholarly journals Trends in First-Line Glucose-Lowering Drug Use in Adults With Type 2 Diabetes in Light of Emerging Evidence for SGLT-2i and GLP-1RA

2021 ◽  
Author(s):  
HoJin Shin ◽  
Sebastian Schneeweiss ◽  
Robert J. Glynn ◽  
Elisabetta Patorno
Keyword(s):  
Type 2 Diabetes ◽  
Line Treatment ◽  
Medicare Beneficiaries ◽  
First Line ◽  
Adult Type ◽  
Antidiabetic Treatment ◽  
Glucagon Like Peptide 1 ◽  
Lowering Drug ◽  
First Line Treatment

<p>Objective: We evaluated recent utilization trends and predictors of first-line antidiabetic treatment in patients with type 2 diabetes.</p> <p>Research Design and Methods: Using two large U.S. health insurance databases (Clinformatics and Medicare), we identified adult type 2 diabetes patients who initiated antidiabetic treatment from 2013 through 2019. Quarterly trends in use of first-line antidiabetic treatment were plotted overall and stratified by cardiovascular disease (CVD). Multinomial logistic regressions were fit to estimate predictors of first-line antidiabetic treatment, using metformin, the recommended first-line treatment for type 2 diabetes, as the common referent.</p> <p>Results: Metformin was the most frequently initiated medication used by 80.6% of Medicare beneficiaries and 83.1% of commercially insured patients. Sulfonylureas were used by 8.7% (Medicare) and 4.7% (commercial). Both populations had low use of sodium-glucose cotransporter 2 inhibitors (SGLT-2i, 0.8% [Medicare] and 1.7% [commercial]) and glucagon-like peptide 1 receptor agonists (GLP-1RA, 1.0% [Medicare] and 3.5% [commercial]), with increasing trends over time (P < 0.01). Initiators of antidiabetic drugs with established cardiovascular benefits (SGLT-2i and GLP-1RA) were more likely to be younger, and had prevalent CVD or higher socioeconomic status compared with initiators of metformin. </p> <p>Conclusions: Among adult patients with type 2 diabetes, metformin was by far the most frequent first-line treatment. While the use of SGLT-2i and GLP-1RA was low from 2013 through 2019, it increased among patients with CVD.</p>

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