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Treatment Trends in Type 2 Diabetes

Physicians favor aggressive glycemic control, survey finds (October 2)

Decision Resources, a research and advisory firm located in Burlington, Mass., finds that, through analysis of U.S. longitudinal patient-level claims data, dipeptidyl peptidase IV (DPP-IV) inhibitors claim the largest share among branded oral therapies of newly diagnosed patients with type 2 diabetes across all three lines of therapy. DPP-IV inhibitors include Januvia (sitagliptin, Merck), Onglyza (saxagliptin, Bristol-Myers Squibb/AstraZeneca), and Tradjenta (linagliptin, Boehringer Ingelheim).

According to the new report, metformin and sulfonylureas continue to dominate first-line treatment of type 2 diabetes. Long-acting insulins are also more heavily used as a first-line therapy than the DPP-IV inhibitors, despite American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD) guidelines recommending oral antidiabetic therapy prior to insulin administration.

The report examines type 2 diabetes patients treated in the first quarter of 2013 and presents a retrospective analysis of the preceding 2 years of therapy. The trend analysis found that, among recently treated patients, rapid- and long-acting insulins continue to gain patient share. The patient shares for DPP-IV inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists are also growing steadily, which is likely at the expense of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonists.

“The increased use of long-acting insulins, such as Sanofi’s Lantus [insulin glargine injection], as a first-line treatment may indicate that physicians are implementing more aggressive initial therapy than is suggested in the treatment guidelines in an attempt to improve glycemic control,” said analyst Eamonn O’Connor, PhD. “However, the increased use of rapid-acting insulins would indicate that current long-acting insulins are failing to provide complete 24-hour glycemic control.”

Source: Decision Resources; October 2, 2013.

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