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NCT03092752

Clinical Characteristics and Practice Patterns of Type 2 Diabetes Mellitus Patients Treated With OADs in Japan: Analysis of Medical and Health Care Database of the MDV

Completed Results posted Last updated 5 July 2019
What this trial tests

trial testing oral antidiabetic drugs in Diabetes Mellitus, Type 2 in 162,116 participants. Completed in 1 March 2017.

Timeline
1 March 2017
Primary endpoint
1 March 2017
1 March 2017

Quick facts

Lead sponsorBoehringer Ingelheim
StatusCompleted
Study typeOBSERVATIONAL
Enrollment162,116
Start date1 March 2017
Primary completion1 March 2017
Estimated completion1 March 2017
Sites1 location across Japan

Drugs / interventions tested

Conditions studied

Sponsor

Boehringer Ingelheim — full company profile →

Who can join

40 and older, any sex, with Diabetes Mellitus, Type 2. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Prescriptions of OAD by Each Renal Impairment (RI) Stages Secondary · Within 6 months from index date

This outcome observes number of index dates for each class of OAD as per RI classes. RI classes were defined based on eGFR values. Results observed were based on index dates used for comparing drugs between the classes.

DPP4 inhibitors
GroupValue95% CI
Group G11592
Group G24877
Group G33566
Group G4+1411
Total11446
Biguanides (BG)
GroupValue95% CI
Group G1838
Group G22373
Group G31045
Group G4+67
Total4323
Sulfonylurea (SU)
GroupValue95% CI
Group G1530
Group G21446
Group G31090
Group G4+208
Total3274
α-glucosidase (AGI)
GroupValue95% CI
Group G1429
Group G21175
Group G31055
Group G4+488
Total3147
Glinide
GroupValue95% CI
Group G1252
Group G2691
Group G3610
Group G4+337
Total1890
Thiazolidinedione (TZD)
GroupValue95% CI
Group G1227
Group G2626
Group G3410
Group G4+43
Total1306
Number of Index Dates Primary · From 1st January 2014 to 30th September 2016 (At index date)

The date at which patients having their first prescription for any study drugs between 1st January 2014 and 30th September 2016 is defined as index date. Results observed were based on index dates used for comparing drugs between the classes. The reported data represent the number of time a prescription was written between 1st January 2014 and 30th September 2016.

Dipeptidyl-peptidase 4 inhibitor (DPP4i)
GroupValue95% CI
Oral Antibiotic Drugs91634
Biguanides (BG)
GroupValue95% CI
Oral Antibiotic Drugs33238
Sulfonylurea (SU)
GroupValue95% CI
Oral Antibiotic Drugs28211
α-glucosidase (AGI)
GroupValue95% CI
Oral Antibiotic Drugs26192
Glinide
GroupValue95% CI
Oral Antibiotic Drugs16787
Thiazolidinedione (TZD)
GroupValue95% CI
Oral Antibiotic Drugs10344
Age (Years) Primary · From 1st January 2014 to 30th September 2016 (At index date)

Age of all patients in years calculated for index dates computed from patients in the database. Analysis was done based on index dates used for comparing drugs between the classes. The reported data represent the number of time a prescription was written between 1st January 2014 and 30th September 2016.

GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)71.6± 11
Biguanides (BG)66.5± 11
Sulfonylurea (SU)72± 11.1
α-glucosidase (AGI)71.4± 10.8
Glinide71.4± 10.8
Thiazolidinedione (TZD)69.7± 11.4
Total70.7± 11.2
Sex (Male/Female) Primary · From 1st January 2014 to 30th September 2016 (At index date)

Gender of all patients observed for index dates computed from patients in the database. Results observed were based on index dates used for comparing drugs between the classes. The reported data represent the number of time a prescription was written between 1st January 2014 and 30th September 2016.

Female
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)36018
Biguanides (BG)12681
Sulfonylurea (SU)10940
α-glucosidase (AGI)9951
Glinide6549
Thiazolidinedione (TZD)3854
Total79993
Male
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)55616
Biguanides (BG)20557
Sulfonylurea (SU)17271
α-glucosidase (AGI)16241
Glinide10238
Thiazolidinedione (TZD)6490
Total126413
Estimated Glomerular Filtration Rate (eGFR) Primary · Within 6 months from index date

Estimated glomerular filtration rate (eGFR) was calculated based on the age at index date and the latest serum creatinine at index date (or during the observation period) using formula eGFR millilitre/minute/1.73 meter\^2 (mL/min/1.73 m\^2) = 194 × (Creatinine)\^-1.094 × (age in year)\^-0.287 (× 0.739 if female). Analysis was done based on index dates used for comparing drugs between the classes.

GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)63± 28.8
Biguanides (BG)74± 23.9
Sulfonylurea (SU)67.4± 26.4
α-glucosidase (AGI)60.1± 29.4
Glinide59.5± 30.2
Thiazolidinedione (TZD)69.7± 23.7
Total65.2± 28.1
Prescription Rate of Each Class in Each eGFR Renal Impairment (RI) Level Primary · Within 6 months from index date

Renal impairment (RI) is a common complication in patients with type 2 diabetes mellitus (T2DM). Results observed were based on index dates used for comparing drugs between the classes.

90 < eGFR
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)1592
Biguanides (BG)838
Sulfonylurea (SU)530
α-glucosidase (AGI)429
Glinide252
Thiazolidinedione (TZD)227
Total3868
60 < eGFR < 90
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)4877
Biguanides (BG)2373
Sulfonylurea (SU)1446
α-glucosidase (AGI)1175
Glinide691
Thiazolidinedione (TZD)626
Total11188
30 < eGFR < 60
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)3566
Biguanides (BG)1045
Sulfonylurea (SU)1090
α-glucosidase (AGI)1055
Glinide610
Thiazolidinedione (TZD)410
Total7776
eGFR < 30
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)1411
Biguanides (BG)67
Sulfonylurea (SU)208
α-glucosidase (AGI)488
Glinide337
Thiazolidinedione (TZD)43
Total2554
Percentage of Concomitant Medications by OAD Classes Primary · On the index month

Concomitant medication is the drug prescribed other than drug under study in the OAD class on index date. Results observed were based on index dates used for comparing drugs between the classes.

Use of DPP-4 inhibitors (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)3
Biguanides (BG)40
Sulfonylurea (SU)32
α-glucosidase (AGI)37
Glinide56
Thiazolidinedione (TZD)34
Total23
Use of Biguanides (BG) (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)9
Biguanides (BG)0
Sulfonylurea (SU)11
α-glucosidase (AGI)12
Glinide20
Thiazolidinedione (TZD)19
Total10
Use of Sulfonylurea (SU) (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)9
Biguanides (BG)17
Sulfonylurea (SU)1
α-glucosidase (AGI)13
Glinide4
Thiazolidinedione (TZD)21
Total10
Use of α-glucosidase (AGI) (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)8
Biguanides (BG)9
Sulfonylurea (SU)6
α-glucosidase (AGI)2
Glinide16
Thiazolidinedione (TZD)10
Total8
Use of Glinide (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)2
Biguanides (BG)3
Sulfonylurea (SU)1
α-glucosidase (AGI)4
Glinide4
Thiazolidinedione (TZD)4
Total3
Use of Thiazolidinedione (TZD) (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)2
Biguanides (BG)4
Sulfonylurea (SU)2
α-glucosidase (AGI)3
Glinide6
Thiazolidinedione (TZD)1
Total3
Use of Insulin (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)27
Biguanides (BG)23
Sulfonylurea (SU)25
α-glucosidase (AGI)31
Glinide37
Thiazolidinedione (TZD)24
Total27
Percentage of Previous Medications (Premedications) by OAD Classes. Primary · On the index month

Previous medication is the drug prescribed other than drug under study in the OAD class before index date. Results observed were based on index dates used for comparing drugs between the classes

Use of DPP4 inhibitors (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)0
Biguanides (BG)3
Sulfonylurea (SU)2
α-glucosidase (AGI)1
Glinide3
Thiazolidinedione (TZD)8
Total1
Use of Biguanides (BG) (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)2
Biguanides (BG)0
Sulfonylurea (SU)1
α-glucosidase (AGI)2
Glinide3
Thiazolidinedione (TZD)2
Total1
Use of Sulfonylurea (SU) (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)3
Biguanides (BG)2
Sulfonylurea (SU)0
α-glucosidase (AGI)3
Glinide19
Thiazolidinedione (TZD)2
Total4
Use of α-glucosidase (AGI) (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)2
Biguanides (BG)2
Sulfonylurea (SU)1
α-glucosidase (AGI)0
Glinide8
Thiazolidinedione (TZD)1
Total2
Use of Glinide (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)1
Biguanides (BG)1
Sulfonylurea (SU)3
α-glucosidase (AGI)2
Glinide0
Thiazolidinedione (TZD)0
Total1
Use of Thiazolidinedione (TZD) (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)2
Biguanides (BG)2
Sulfonylurea (SU)1
α-glucosidase (AGI)1
Glinide1
Thiazolidinedione (TZD)0
Total1
Use of Insulin (in%)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)9
Biguanides (BG)7
Sulfonylurea (SU)12
α-glucosidase (AGI)10
Glinide12
Thiazolidinedione (TZD)8
Total9
Percentage of Comorbidities by OAD Classes. Primary · On the index month

The additional diseases co-occuring, defined by International classification of Diseases, tenth revision (ICD-10) code. Results observed were based on index dates used for comparing drugs between the classes.

Hypertension (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)69
Biguanides (BG)66
Sulfonylurea (SU)66
α-glucosidase (AGI)70
Glinide73
Thiazolidinedione (TZD)68
Total68
Ischemic heart disease (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)30
Biguanides (BG)27
Sulfonylurea (SU)29
α-glucosidase (AGI)33
Glinide33
Thiazolidinedione (TZD)28
Total30
Myocardial infarction (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)14
Biguanides (BG)13
Sulfonylurea (SU)14
α-glucosidase (AGI)15
Glinide14
Thiazolidinedione (TZD)12
Total14
Heart failure (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)25
Biguanides (BG)19
Sulfonylurea (SU)23
α-glucosidase (AGI)27
Glinide28
Thiazolidinedione (TZD)19
Total24
Stroke (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)26
Biguanides (BG)22
Sulfonylurea (SU)26
α-glucosidase (AGI)26
Glinide27
Thiazolidinedione (TZD)25
Total25
Renal impairment (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)19
Biguanides (BG)10
Sulfonylurea (SU)14
α-glucosidase (AGI)23
Glinide26
Thiazolidinedione (TZD)11
Total18
Diabetic foot (in %)
GroupValue95% CI
Dipeptidyl-peptidase 4 Inhibitor (DPP4i)9
Biguanides (BG)8
Sulfonylurea (SU)9
α-glucosidase (AGI)10
Glinide14
Thiazolidinedione (TZD)8
Total9

Sponsor's own description

Appropriate use of oral antidiabetic drugs (OADs) including dose-reduction is important for patient's safety in T2DM patients with renal impairment (RI). However, there are insufficient data on dose adjustment in accordance with the prescription pattern and the risk of RI of OADs, in particular Dipeptidyl-peptidase-4 inhibitors, in clinical practice in Japan. Therefore, we will investigate OADs usage conditions and dose selection in T2DM patients with RI in clinical practice in Japan

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Persistence of oral antidiabetic treatment for type 2 diabetes characterized by drug class, patient characteristics and severity of renal impairment: A Japanese database analysis.
    Kadowaki T, Sarai N, Hirakawa T, Taki K, et al · · 2018 · cited 18× · PMID 29974673 · DOI 10.1111/dom.13463

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