National trends in the treatment of diabetic nephropathy in the United States.

What is known and objective The prevalence of diabetic nephropathy continues to rise and it remains a strong predictor of morbidity and mortality in diabetic patients. Patients diagnosed with diabetic nephropathy are actively excluded from most trials involving diabetic medications and it is importa...

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Publicado en:Journal of Clinical Pharmacy & Therapeutics Vol. 42; no. 3; pp. 311 - 318
Autores principales: Ajiboye, O., Segal, J. B.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2017
      vid: 42
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: National trends in the treatment of diabetic nephropathy in the United States.
      aug:
        au:
          Ajiboye, O.
          Segal, J. B.
        affil: Johns Hopkins Bloomberg School of Public Health, Baltimore MD, USA
      sug:
        subj:
          Diabetic Nephropathies Drug Therapy
          Prescribing Patterns
          Sulfonylurea Compounds Administration and Dosage
          Dipeptidyl Peptidase 4 Inhibitors Administration and Dosage
          Human
          Descriptive Statistics
          Confidence Intervals
          Diabetic Nephropathies Epidemiology
          United States
      ab: What is known and objective The prevalence of diabetic nephropathy continues to rise and it remains a strong predictor of morbidity and mortality in diabetic patients. Patients diagnosed with diabetic nephropathy are actively excluded from most trials involving diabetic medications and it is important to understand the prescription patterns in this subset of patients with diabetes. Methods Using the IMS Health's National Disease and Therapeutic Index, we analysed the medication prescription patterns for six classes of medications from 2010 to 2014 among patients, 35 years or older, with diabetic nephropathy. Results Annual office visits increased from 772 860 (95% confidence interval (CI), 755, 470-790, 249) in 2010 to 1 868 618 (95% CI, 1 834 422-1 902 814) in 2013 and declined to 830 596 (95% CI, 809 167-852 025) in 2014. Sulfonylureas and dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) were the most frequently used of the four classes of diabetic medications included in this study. DPP-4 inhibitors use increased gradually and was used in 54% (95% CI 49-58) of treatment visits by the last quarter of 2014. Across these years, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (ACEIs and ARBs) were prescribed in the majority of treatment visits with peaks above 90%. However, there were some periods when utilization of these antihypertensives was low. What is new and conclusions Significant increases occurred in the uptake of new diabetic medications; DPP-4 inhibitors and SGLT-2 inhibitors and in the utilization of ACEIs and ARBs compared to the findings reported in other studies with increased complexity in the treatment of patients with diabetic nephropathy. Improved and continued used of these medications may be beneficial in improving patient outcomes.
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    language: English
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