Patients’ Preference Between DPP4i and SGLT2i for Type 2 Diabetes Treatment: A Cross-Sectional Evaluation

Abstract

José Esteban Costa Gil,1 Juan Carlos Garnica Cuéllar,2 Paula Perez Terns,3 Aldo Ferreira-Hermosillo,4 José Antonio Cetina Canto,5 Ángel Alfonso Garduño Perez,2 Pedro Mendoza Martínez,6 Lucas Rista,7 Alejandro Sosa-Caballero,6 Estefanía Vázquez-Mendez,8 Luis Fernando Tejado Gallegos,8 Hungta Chen,9 Agustina Elizalde,10 Virginia B Tomatis10 1Departamento de Endocrinología, Instituto de Cardiología La Plata, La Plata, Buenos Aires, Argentina; 2Departamento de Endocrinología del Centro Médico Nacional “ 20 de Noviembre”, ISSSTE, Ciudad de México, México; 3Dirección Médica, Cardiología Palermo - Centro de Investigaciones Clínicas, Buenos Aires, Argentina; 4Unidad de Investigación Médica en Enfermedades Endócrinas. Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México; 5Hospital Regional ISSSTE, Mérida, Yucatán estado, México; 6Endocrinología, Hospital Angeles Lindavista, Ciudad de México, México; 7Diabetes, Innovación e Investigación, Centro de Diabetes y Nutrición - Investigaciones Clínicas (CEDyN), Rosario, Santa Fé, Argentina; 8Medical Affairs, AstraZeneca - México, Ciudad de México, México; 9Global Medical & Payer Evidence Statistics, AstraZeneca, Gaithersburg, Maryland, USA; 10Medical Affairs, AstraZeneca – South Cone, Buenos Aires, ArgentinaCorrespondence: José Esteban Costa Gil, Costa Gil Departamento de Endocrinología, Instituto de Cardiología La Plata, Calle 6, número 212, La Plata, 1900, Buenos Aires, Argentina, Tel [phone], Email [email protected]: Despite newer type 2 diabetes (T2D) medications, patients do not always achieve metabolic targets, remaining at risk for cardiorenal complications. Therapeutic decisions are generally made by the healthcare team without considering patients’ preferences. We aimed to evaluate patients’ T2D treatment preference in two Latin-American countries between two different oral medication profiles, one resembling dipeptidyl peptidase-4 inhibitors (DPP4i) and another resembling sodium-glucose cotransporter-2 inhibitors (SGLT2i).Patients and Methods: In this cross-sectional, multicenter study from June to September 2020, patients with T2D from Argentina and Mexico (n = 390) completed a discrete choice experiment questionnaire to identify preferences between DPP4i (medication profile A) and SGLT2i (medication profile B). The reason behind patients’ choice, and the association between their baseline characteristics and their preference were evaluated using logistic regression methods.Results: Most participants (88.2%) preferred SGLT2i’s profile. Participants with older age (p = 0.0346), overweight or obesity (p < 0.0001), high blood pressure (BP; p < 0.0001), high total cholesterol (p = 0.0360), and glycosylated hemoglobin (HbA1c) < 7% (p = 0.0001) were more likely to choose SGLT2i compared with DPP4i’s profile. The most and least important reasons to choose either drug profile were HbA1c reduction and genital infection risk, respectively. The likelihood of selecting the SGLT2i’s profile significantly increased in participants with increased body mass index (BMI; odds ratio [OR] = 8.9, 95% confidence interval [CI]: 3.5– 22.5, p < 0.05), high BP (OR = 4.9, 95% CI: 1.9– 12.4, p < 0.05), and lower education level (OR = 3.6, 95% CI: 1.0– 12.6, p < 0.05).Conclusion: Latin-American patients with T2D preferred medication with a profile resembling SGLT2i over one resembling DPP4i as a treatment option. A patient-centered approach may aid the healthcare team in decision-making for improved outcomes.Keywords: dipeptidyl peptidase-4 inhibitors, patient preference, sodium-glucose cotransporter-2 inhibitors, type 2 diabetes

Keywords

• dipeptidyl peptidase-4 inhibitors
• patient preference
• sodium-glucose cotransporter-2 inhibitors
• type 2 diabetes.