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Article: Cardio-renal outcomes and the direct medical cost of type 2 diabetes patients treated with sodium glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists: A population-based cohort study

TitleCardio-renal outcomes and the direct medical cost of type 2 diabetes patients treated with sodium glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists: A population-based cohort study
Authors
KeywordsCardiovascular disease
Glucagon-like peptide-1 receptor agonists
Sodium glucose cotransporter-2 inhibitors
Costs
Type 2 diabetes
Issue Date2021
PublisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/diabres
Citation
Diabetes Research and Clinical Practice, 2021, v. 180, article no. 109071 How to Cite?
AbstractAims: To compare cardio-renal outcomes and incurred direct medical costs of patients initiating sodium glucose cotransporter-2 inhibitors (SGLT2i) versus glucagon-like peptide-1 receptor agonists (GLP-1RA). Methods: A population-based cohort of patients with type 2 diabetes was identified from Hong Kong Hospital Authority. Patients who were free from cardiovascular and end-stage renal diseases at baseline, and newly treated with SGLT2i (n = 2,541) or GLP-1RA (n = 303), were included. Risks of developing cardio-renal complications, incurred direct medical costs, and changes in clinical parameters were assessed between groups. Results: Over a median follow-up of 12.5 months in SGLT2i group and 25.5 months in GLP-1RA group, SGLT2i users were associated with significantly lower risk of heart failure compared with those on GLP-1RA [hazard ratio = 0.183, 95 %CI = (0.045, 0.745)]. 1-year change in clinical parameters also favored use of SGLT2i over GLP-1RA, where the former was associated with a larger reduction in fasting glucose level [difference-in-difference = −0.87 mmol/L, 95 %CI = (−1.42, −0.33), p = 0.002]. The two groups had comparable direct medical costs after 1-year of follow-up. Conclusion: Patients initiating SGLT2i experienced a significantly lower risk of heart failure than those on GLP-1RA, alongside better glycemic control through a larger reduction in fasting glucose level over one-year follow-up, while direct medical cost incurred was comparable to that of GLP-1RA.
Persistent Identifierhttp://hdl.handle.net/10722/304680
ISSN
2020 Impact Factor: 5.602
2020 SCImago Journal Rankings: 1.605
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTang, EHM-
dc.contributor.authorWong, CKH-
dc.contributor.authorLau, KTK-
dc.contributor.authorFei, Y-
dc.contributor.authorCheung, BMY-
dc.date.accessioned2021-10-05T02:33:36Z-
dc.date.available2021-10-05T02:33:36Z-
dc.date.issued2021-
dc.identifier.citationDiabetes Research and Clinical Practice, 2021, v. 180, article no. 109071-
dc.identifier.issn0168-8227-
dc.identifier.urihttp://hdl.handle.net/10722/304680-
dc.description.abstractAims: To compare cardio-renal outcomes and incurred direct medical costs of patients initiating sodium glucose cotransporter-2 inhibitors (SGLT2i) versus glucagon-like peptide-1 receptor agonists (GLP-1RA). Methods: A population-based cohort of patients with type 2 diabetes was identified from Hong Kong Hospital Authority. Patients who were free from cardiovascular and end-stage renal diseases at baseline, and newly treated with SGLT2i (n = 2,541) or GLP-1RA (n = 303), were included. Risks of developing cardio-renal complications, incurred direct medical costs, and changes in clinical parameters were assessed between groups. Results: Over a median follow-up of 12.5 months in SGLT2i group and 25.5 months in GLP-1RA group, SGLT2i users were associated with significantly lower risk of heart failure compared with those on GLP-1RA [hazard ratio = 0.183, 95 %CI = (0.045, 0.745)]. 1-year change in clinical parameters also favored use of SGLT2i over GLP-1RA, where the former was associated with a larger reduction in fasting glucose level [difference-in-difference = −0.87 mmol/L, 95 %CI = (−1.42, −0.33), p = 0.002]. The two groups had comparable direct medical costs after 1-year of follow-up. Conclusion: Patients initiating SGLT2i experienced a significantly lower risk of heart failure than those on GLP-1RA, alongside better glycemic control through a larger reduction in fasting glucose level over one-year follow-up, while direct medical cost incurred was comparable to that of GLP-1RA.-
dc.languageeng-
dc.publisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/diabres-
dc.relation.ispartofDiabetes Research and Clinical Practice-
dc.subjectCardiovascular disease-
dc.subjectGlucagon-like peptide-1 receptor agonists-
dc.subjectSodium glucose cotransporter-2 inhibitors-
dc.subjectCosts-
dc.subjectType 2 diabetes-
dc.titleCardio-renal outcomes and the direct medical cost of type 2 diabetes patients treated with sodium glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists: A population-based cohort study-
dc.typeArticle-
dc.identifier.emailTang, EHM: erichm@hku.hk-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailLau, KTK: kristytk@hku.hk-
dc.identifier.emailCheung, BMY: mycheung@hkucc.hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityCheung, BMY=rp01321-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.diabres.2021.109071-
dc.identifier.pmid34592391-
dc.identifier.scopuseid_2-s2.0-85116692126-
dc.identifier.hkuros326377-
dc.identifier.volume180-
dc.identifier.spagearticle no. 109071-
dc.identifier.epagearticle no. 109071-
dc.identifier.isiWOS:000708521100008-
dc.publisher.placeIreland-

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