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Trends in clinical characteristics and factors associated with initial prescription of SGLT2 inhibitors in Japanese patients with type 2 diabetes mellitus

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A Correction to this article was published on 12 December 2023

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Abstract

Aims

To investigate the changes in patient background and treatment lines between 2016–2019 and contributing factors when sodium-glucose co-transporter 2 inhibitors (SGLT2i) are newly prescribed for type 2 diabetes mellitus patients.

Methods

The subjects comprised patients who had attended outpatient clinics at the four Jikei University School of Medicine-affiliated hospitals. One-way analysis of variance was used to evaluate annual changes in patients’ characteristics. Logistic regression analysis was also used to explore factors contributing to the treatment lines.

Results

The age of the 1951 subjects [mean ± SD] was 59.1 ± 12.8 years; BMI 27.5 ± 4.9 kg/m2; HbA1c 8.15 ± 1.24%; eGFR 74.2 ± 25.3 ml/min/1.73m2. SGLT2i was the 2.86th (± 1.22) new prescription among antidiabetic drugs, and at increasingly earlier treatment lines between 2016 and 2019 (3.28 ± 1.16 to 2.59 ± 1.19; P < 0.001). The age of initial SGLT2i prescription significantly increased over time (P < 0.001). In contrast, the patients’ BMI and eGFR values decreased over time. Again, the proportions of patients with chronic kidney disease (CKD) and cardiovascular disease-heart failure disease (CVD-HF) tended to increase over time. The patients for whom SGLT2i had been prescribed in the first line were more likely to have obesity and HF (1.64 [1.15–2.34] and 1.84 [1.12–3.02], respectively).

Conclusions

SGLT2i was more likely to be newly prescribed to patients with CVD-HF and CKD, older patients, and to be prescribed in earlier treatment lines in recent years. Obesity and HF were predictor of SGLT2i prescriptions in the first line.

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Acknowledgements

The authors would like to give special thanks to the study participants. The authors received no specific funding for this work.

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Authors and Affiliations

  1. Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Hiroshi Takahashi, Yuka Suganuma, Takayuki Ohno & Rimei Nishimura

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  1. Hiroshi Takahashi
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  2. Yuka Suganuma
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  3. Takayuki Ohno
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  4. Rimei Nishimura
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Correspondence to Hiroshi Takahashi.

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Conflict of interest

Rimei Nishimura has participated in speakers’ bureaus/advisory panels for Astellas, Boehringer Ingelheim, Eli Lilly, Kissei, Medtronic, Novo Nordisk, Sanofi, Takeda, Novartis, and MSD and served as subsidies or donatins for Ono, Boehringer Ingelheim, Takeda, and Taisho. The other authors haven no conflict of interest to declare.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Ethics Committee of Jikei University School of Medicine/November 12, 2018/No. 30–273 [9294]) and with the Helsinki Declaration of 1964 and later versions. This study used samples and medical information collected in the past in the course of normal medical care. Individual informed consent was not taken, but documents approved by the Ethics Committee were posted on the website to make the information available to the public, and the opportunity to refuse was provided.

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Figure Sup.

Trends in patients with CKD or CVD-HF in those aged ≥ 75 years and < 75 years (2016–2019). CKD Chronic Kidney Disease, CVD-HF Cardiovascular Disease-Heart Failure. *p values for trend < 0.05 (TIF 951 KB)

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Takahashi, H., Suganuma, Y., Ohno, T. et al. Trends in clinical characteristics and factors associated with initial prescription of SGLT2 inhibitors in Japanese patients with type 2 diabetes mellitus. Diabetol Int 13, 606–614 (2022). https://doi.org/10.1007/s13340-022-00577-y

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