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This section of the website is for UK healthcare professionals only. If you are not a healthcare professional, please click here.

First ‘time-to-insulin’ data with DPP-4 inhibitor vs. an SU

In a real world study, JANUVIA when added to metformin, was associated with longer time to insulin initiation than SU’s added to metformin4

  • In a real world evidence (RWE) setting, patients treated with JANUVIA and metformin were 24% less likely to initiate insulin than patients treated with metformin and SU (HR 0.76; 95% CI 0.65 – 0.90)
  • In the tests used to estimate the number and proportion of patients who initiated insulin within 1, 2, 3, 4, 5 and 6 years from the index date, there was a statistically reduced risk of insulin initiation among sitagliptin patients at year 4 and year 5 versus SU patients.

Kaplan-Meier cumulative distribution function for time-to-first-insulin (matched-pair sample, n=7,728)

IMG_Time to insulin

Adapted from Inzucchi et al 2015

Study Design

A retrospective cohort study design using the USA GE Centricity Electronic Medical Record database, which captured data from 7,728 patients prescribed either sitagliptin or an SU as dual therapy between October 2006 and May 2013. The primary objective was to assess and contrast the differences in the time to insulin initiation between metformin and sitagliptin dual therapy versus metformin and an SU dual therapy. Propensity score matching was then used to mitigate underlying differences in covariates between the cohorts, and a multivariable logistic regression was used to build the propensity score model.

Inclusion criteria:

  • ≥1 prescription of SITA or SU during the index period
  • Age ≥ 18 yrs as of the index date
  • Continuous medical recording ≥1 year before index date (baseline) and ≥90 days after index date
  • Any MET use on or within 1 year before the index date
  • Continuous use of only MET+SITA or MET+SU for ≥ 90 days after the index date. Index date was defined as the date of the first prescription of SITA or SUs used as dual therapy with metformin in the index period

Patients included in the study were followed until insulin initiation or until the end of data collection.

Reference:

4. Inzucchi SE et al. Progression to insulin therapy among type 2 diabetes patients treated with sitagliptin or sulfonylurea plus metformin dual therapy. Diabetes Obes Metab. 2015; 17 (10): 956-964.