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Abstract: SA-PO489

Treatment Utilization and Disease Burden Associated with CKD Progression in Patients with Type 2 Diabetes

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Amamoo, James J., Novo Nordisk Inc, Plainsboro, New Jersey, United States
  • Brady, Brenna L., Merative, Cambridge, Massachusetts, United States
  • Noone, Josh, Novo Nordisk Inc, Plainsboro, New Jersey, United States
  • Xie, Lin, Novo Nordisk Inc, Plainsboro, New Jersey, United States
  • Mehanna, Sherif, Novo Nordisk Inc, Plainsboro, New Jersey, United States
  • Varker, Helen V., Merative, Cambridge, Massachusetts, United States
  • Bakris, George L., University of Chicago, Chicago, Illinois, United States
Background

Effective management of type 2 diabetes (T2D) is important for preventing/delaying complications, such as chronic kidney disease (CKD). This real-world, retrospective cohort study examined clinical characteristics and antidiabetic treatment utilization, particularly sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs), in patients with CKD and T2D.

Methods

Data were obtained from the MerativeTM MarketScan® Explorys Claims-Electronic Health Record Database (January 1, 2016, to September 30, 2021). Patients were aged ≥18 years and had ≥2 estimated glomerular filtration rate (eGFR) values between 15 and 89 mL/min, indicating the same CKD stage within a 90-day period. The first eGFR value qualifying for inclusion was the index date, and patients were continuously enrolled for 6 months pre-index and 12 months post-index. Patients had diagnoses of CKD and T2D in the pre-index period. Treatment utilization was reported by CKD stages 2–3b; all analyses were descriptive.

Results

: A total of 7,261 patients were included (mean ± SD age, 72.4 ± 10.6 years; 56.4% male). Patients had CKD stage 2 (28.0%), 3a (27.4%), 3b (29.5%), or 4 (15.1%). At pre-index, 4.2% and 7.8% of patients received SGLT2is and GLP-1RAs, respectively. At post-index, on average, 43.3% of patients across CKD stages 2–3b received metformin, 10.4% received GLP-1RAs, and 7.3% received SGLT2is; decreasing use of these agents was observed with CKD progression (Figure). In a subset of patients with poor glycemic control (glycated hemoglobin >7%; n=2,921), metformin, SGLT2i and GLP-1RA utilization was low; 18.2–30.1% received SGLT2is or GLP-1RAs (Figure).

Conclusion

Despite a large number of patients with comorbid CKD and T2D having poor glycemic control, SGLT2i and/or GLP-1RA utilization was low. Improved diabetes management is needed in this patient population.