Add-On Sitagliptin vs. Sulphonylurea Compared on Insulin Initiation Risk
(HealthDay News) — For patients with type 2 diabetes mellitus (T2DM) treated with metformin, add-on sitagliptin is associated with a lower risk of insulin initiation than add-on sulphonylurea, according to a study published in the October issue of Diabetes, Obesity and Metabolism.
Silvio E. Inzucchi, MD, from the Yale University School of Medicine in New Haven, CT, and colleagues conducted a retrospective cohort study to examine time to insulin initiation among patients with T2DM treated with sitagliptin versus sulphonylurea as an add-on to metformin. Participants were aged 18 years and older with continuous medical records and an initial prescription of sitagliptin or sulphonylurea with metformin for 90 days or more during 2006–2013. A total of 3,864 propensity-score-matched pairs were analyzed.
The researchers found that the risk of insulin initiation was lower for sitagliptin users vs. sulphonylurea users over six years (26.6 vs. 34.1%). After adjustment for baseline characteristics, the findings persisted (hazard ratio, 0.76; 95% confidence interval, 0.65–0.9). Compared with sulphonylurea users, sitagliptin users were less likely to initiate insulin in conditional logistic regression analyses.
"In this real-world matched cohort study, patients with T2DM treated with sitagliptin had a significantly lower risk of insulin initiation compared with patients treated with sulphonylurea, both as add-on to metformin," the authors write.
Several authors disclosed financial ties to pharmaceutical companies, including Merck, the manufacturer of sitagliptin.