HealthCore study is the first to report a direct comparison of two new medication classes on risk of heart failure hospitalization.
September 7, 2017–INDIANAPOLIS–(BUSINESS WIRE)–Seniors with type 2 diabetes or those with diabetic complications were less likely to be hospitalized for heart failure while taking a sodium-glucose co-transporter 2 (SGLT2) inhibitor compared to dipeptidyl peptidase-4 (DPP4) inhibitors, another new class of oral antidiabetic drug, according to a study released in Cardiovascular Diabetology and conducted by Anthem, Inc. and HealthCore.
The study is the first to report a direct comparison of SGLT2 and DPP4 inhibitors on the risk of heart failure hospitalization. People with type 2 diabetes are at increased risk of serious health complications, and the risk of heart failure alone is four- to fivefold higher among patients with diabetes than those without the condition. Patients with diabetes also face a higher risk of recurrent heart failure, compared with people without diabetes. Food and Drug Administration guidelines recommend doctors evaluate patients for cardiovascular risk before prescribing medication to manage diabetes.
SGLT2 inhibitors and DPP4 inhibitors are the latest addition to the type 2 diabetes treatment arsenal and are recommended as second-line treatment after metformin. Both SGLT2 and DPP4 inhibitors have received attention for their effect on cardiovascular outcomes, with clinical trials finding a reduction in cardiovascular events, including heart failure admissions with empaglifozin and canagliflozin – both SGLT2 inhibitors — compared to placebo. However, there has been very limited information on how these findings compare to patients who use other medications.
“This study provides further insight into the clinical benefits observed in the real-world for individuals using certain classes of medications, and the potential for reducing medical complications,” said Jeff White, Anthem’s staff vice president of clinical pharmacy services. “Nearly two in five Americans are expected to develop type 2 diabetes during their lifetime1, according to the Centers for Disease Control and Prevention, and our finding is intriguing in light of the overwhelming interest around the reduction of heart failure risks associated with SGLT2 inhibitors to treat patients with diabetes.”
The HealthCore study found that the heart failure hospitalization risk is 32 percent lower for new users of SGLT2 compared to DPP4 medications. In most patients younger than 65 or without history of diabetic complications, there was no risk difference. The majority of the analyzed patients were younger than 65, or didn’t have complications, and there was no risk difference among those.
“Real world studies like this can support findings from clinical trials and provide comparative effectiveness and safety of these medications that have not been studied,” said John Barron, clinical pharmacy scientist with HealthCore, the outcomes research subsidiary of Anthem. “This information can help physicians and other healthcare professionals make better informed decisions about choosing the most appropriate medications for a given patient.”
The study analyzed medical and pharmaceutical data from October 2012 to October 2016, including adults who filled a new prescription for SGLT2 or DPP4 medication classes between April 2013 and December 2014. After matching to ensure the two cohorts were balanced for age, sex and other clinical characteristics, there were 4,899 people in the SGLT2 cohort and 9,798 in the DPP4 cohort. Both groups were followed for approximately two years after beginning medication.
About HealthCore, Inc.
HealthCore, Inc. is the wholly-owned, independently operating health outcomes research subsidiary of Anthem Inc. (NYSE: ANTM). We work with life sciences companies, payers and providers, and government and academic organizations to provide real-world evidence in support of a wide variety of health care decisions. Our research capabilities include extensive experience in HEOR, Late Phase, Safety and Epidemiology and Survey-Based research services and solutions with our work designed to improve quality, safety and affordability in health care. With more than 20 years of experience, clinical and scientific research expertise, and exclusive access to a robust, integrated research environment containing information on nearly 60 million individuals from multiple health plans across the U.S., HealthCore delivers unparalleled clarity and actionable information to health care decision makers. To learn more about HealthCore, go to www.healthcore.com.
About Anthem, Inc.
Anthem is working to transform health care with trusted and caring solutions. Our health plan companies deliver quality products and services that give their members access to the care they need. With over 74 million people served by its affiliated companies, including more than 40 million within its family of health plans, Anthem is one of the nation’s leading health benefits companies. For more information about Anthem’s family of companies, please visit www.antheminc.com/companies.
1 Edward W. PhD; Zhuo, Xiaohui PhD; Cheng, Yjling J PhD; Albright, Ann L.PhD; Narayan, Venkat MD; Thompson, Theodore MS; (2014). Trends in Lifetime Risk and Years of Life Lost Due to Diabetes in the USA, 1985-2011. The Lancet Diabetes & Endocrinology, 2 (11) 867-874. https://doi.org/10.1016/S2213-8587(14)70161-5