Changing Patterns of Antihyperglycaemic Treatment among Patients with Type 2 Diabetes in Hungary between 2015 and 2020—Nationwide Data from a Register-Based Analysis
Abstract
:1. Introduction
2. Material and Methods
- antihyperglycaemic agents (in monotherapy or in combination) in 2015–2020 (assessing prevalence of patients with different treatment regimes)
- antihyperglycaemic agents as initial therapy in 2015–2020 (assessing incidence of patients with initial therapy)
- novel drugs with cardiovascular/renal benefit (either in monotherapy or in combination) after initial therapy with MET or SU (assessing incidence of patients with such treatment after initial MET or SU therapy; for comparison, DPP-4-inhibitors and INS were also analysed).
3. Results
3.1. Prevalence of Patients with Different Treatment Patterns—Use of Antihyperglycaemic Agents in Monotherapy or in Combination between 2015 and 2020
3.2. Incidence of Patients with Initial Therapy—Use of Antihyperglycaemic Agents as Initial Therapy in the Period of 2015–2020
3.3. Incidence (Appearance) of Novel Drugs with Cardiovascular/Renal Benefit (Either in Monotherapy or in Combination) after Initial Therapy with MET or SU
4. Discussion
- Regarding prevalence of patients with traditional antidiabetic drugs, we observed a relatively stable prevalence of patients with MET reaching the highest proportion among monotherapy in 2020. On the other hand, prevalent cases with SUs markedly and those of INS slightly decreased over time. Among novel drugs, DPP-4 inhibitors were the most frequently administered drugs. Although we found a clearly increasing rate of patients with SGLT-2 inhibitors and GLP-1-RAs, these drugs were used only in a small proportion of patients.
- As for initial therapy, patients with MET monotherapy had the highest incidence rate, while SUs—despite their steadily diminishing use—remained the second most frequently chosen initial monotherapy; incidence of patients with INS monotherapy did not change significantly over the entire period.
- After initial therapy with MET or SU, the incidence rates of patients with add-on GLP-1-RAs and those of add-on SGLT-2 inhibitors slowly increased in a relatively narrow range in the subsequent six years.
- Some abrupt alterations in the 6-year-long trends were observed in 2020, probably due to increasing rate of COVID-19 and the closedown in Hungary (from March 2020 onwards).
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Incident Cases (n) | Prevalent Cases (n) | Prevalent Cases with Redeemed Prescriptions of Antidiabetic Drugs (n) | |
---|---|---|---|
2015 | 60,049 | 682,274 | 526,076 |
2016 | 57,726 | 706,617 | 535,220 |
2017 | 54,059 | 727,071 | 541,072 |
2018 | 52,506 | 743,585 | 543,494 |
2019 | 53,279 | 760,032 | 560,142 |
2020 | 29,865 | 752,367 | 540,607 |
2015–2020 | 307,486 | 929,711 | 753,172 |
2015 | 2016 | 2017 | 2018 | 2019 | 2020 | |
---|---|---|---|---|---|---|
Total number of patients with redeemed prescriptions | 526,076 | 535,220 | 541,072 | 543,494 | 560,142 | 540,607 |
Number of patients with traditional agents (monotherapy or combination) | ||||||
MET monotherapy | 144,044 | 155,563 | 162,311 | 165,088 | 187,110 | 165,779 |
INS monotherapy | 150,659 | 152,503 | 151,282 | 149,983 | 147,666 | 143,500 |
SU monotherapy | 195,355 | 181,033 | 166,961 | 155,466 | 144,375 | 133,283 |
OAD + INS combination | 48,916 | 58,037 | 64,580 | 69,059 | 75,875 | 72,357 |
MET + SU | 57,918 | 55,566 | 52,230 | 48,497 | 50,596 | 41,428 |
Number of patients with novel agents (monotherapy or dual combination) | ||||||
MET + DPP-4 inhibitor | 58,700 | 62,108 | 63,934 | 66,083 | 68,331 | 63,734 |
MET + SGLT-2 inhibitor | 2148 | 9578 | 17,770 | 23,640 | 30,544 | 33,144 |
DPP-4 inhibitor | 17,696 | 19,170 | 20,476 | 22,840 | 25,907 | 25,940 |
GLP-1-RAs | 9349 | 9305 | 9357 | 10,717 | 16,495 | 22,683 |
SGLT-2- inhibitor | 4651 | 9121 | 12,579 | 15,087 | 18,150 | 19,163 |
SU + DPP-4 inhibitor | 14,226 | 14,790 | 14,846 | 15,306 | 16,417 | 15,746 |
MET + GLP-1-RA | 4136 | 4367 | 4427 | 4634 | 7395 | 8541 |
SU + SGLT-2 inhibitor | 2286 | 3640 | 4489 | 5297 | 5968 | 6039 |
INS + GLP-1-RA | 673 | 926 | 833 | 1374 | 3172 | 4745 |
DPP-4 inhibitor + SGLT-2 inhibitor | 323 | 838 | 1381 | 1816 | 2434 | 2870 |
Number of patients with novel agents (triple combination) | ||||||
MET + DPP-4 inhibitor + SU | 34,136 | 34,113 | 32,575 | 31,833 | 31,282 | 27,948 |
MET + DPP-4 inhibitor + SGLT-2 inhibitor | 1499 | 4104 | 6705 | 9098 | 12,133 | 13,078 |
MET + SU + SGLT-2 inhibitor | 1438 | 4237 | 7118 | 8974 | 10,555 | 10,751 |
MET + SGLT-2 inhibitor + GLP-1-RA | 171 | 486 | 944 | 1588 | 3261 | 4673 |
OAD + INS + GLP-1-RA | 652 | 900 | 850 | 1081 | 2539 | 3531 |
2015 | 2016 | 2017 | 2018 | 2019 | 2020 | |
---|---|---|---|---|---|---|
Total number of patients with initial redeemed prescriptions | 43,115 | 42,023 | 39,236 | 37,250 | 42,151 | 25,496 |
Number of patients with initial traditional agents (monotherapy or combination) | ||||||
MET monotherapy | 23,060 | 22,901 | 21,889 | 20,128 | 25,278 | 12,710 |
SU monotherapy | 9686 | 8611 | 7006 | 6512 | 5781 | 4194 |
INS monotherapy | 3712 | 3599 | 3197 | 3203 | 2916 | 2481 |
MET + SU | 1587 | 1376 | 1209 | 1054 | 1065 | 653 |
OAD + insulin | 622 | 655 | 653 | 650 | 728 | 631 |
Number of patients with initial novel agents (monotherapy or combination) | ||||||
MET + DPP-4 inhibitor | 2149 | 2119 | 2125 | 2095 | 1924 | 1208 |
GLP-1-RA | 412 | 346 | 427 | 502 | 953 | 921 |
MET + SGLT-2 inhibitor | 85 | 470 | 745 | 822 | 1045 | 851 |
DPP-4 inhibitor | 814 | 926 | 857 | 1086 | 1089 | 769 |
SGLT-2- inhibitor | 358 | 470 | 590 | 631 | 781 | 616 |
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Jermendy, G.; Kiss, Z.; Rokszin, G.; Abonyi-Tóth, Z.; Lengyel, C.; Kempler, P.; Wittmann, I. Changing Patterns of Antihyperglycaemic Treatment among Patients with Type 2 Diabetes in Hungary between 2015 and 2020—Nationwide Data from a Register-Based Analysis. Medicina 2022, 58, 1382. https://doi.org/10.3390/medicina58101382
Jermendy G, Kiss Z, Rokszin G, Abonyi-Tóth Z, Lengyel C, Kempler P, Wittmann I. Changing Patterns of Antihyperglycaemic Treatment among Patients with Type 2 Diabetes in Hungary between 2015 and 2020—Nationwide Data from a Register-Based Analysis. Medicina. 2022; 58(10):1382. https://doi.org/10.3390/medicina58101382
Chicago/Turabian StyleJermendy, György, Zoltán Kiss, György Rokszin, Zsolt Abonyi-Tóth, Csaba Lengyel, Péter Kempler, and István Wittmann. 2022. "Changing Patterns of Antihyperglycaemic Treatment among Patients with Type 2 Diabetes in Hungary between 2015 and 2020—Nationwide Data from a Register-Based Analysis" Medicina 58, no. 10: 1382. https://doi.org/10.3390/medicina58101382