Risultati per: Efficacia e sicurezza dei farmaci GLP-1 per il diabete di tipo 2 e l’obesità

Studio di ricercatori Aou Cagliari su riviste scientifiche

Senza DRG, i pazienti non hanno accesso a farmaci e monitoraggio

Senza DRG, i pazienti non hanno accesso a farmaci e monitoraggio

Università Cattolica, per 2 su 3 non serve il richiamo per Covid

This pooled cross-sectional study explores prescribing rates for glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors among US patients with type 1 diabetes.

L’importanza dei fit-test e i rischi per gli operatori sanitari

I moderni dispositivi permettono di adattare la terapia insulinica alle esigenze individuali di ciascun paziente, migliorando l’efficacia del trattamento

Sitd, crescita fenomeni preoccupa soprattutto tra i giovani

Medicinali più consumati sono per cuore, intestino e sangue

Cherubini (Siedp) “evitabili in oltre 450 bimbi ogni anno”

We appreciate the constructive dialogue from Cheng on our study’s findings.1 We agree that any clinical database study has limitations that necessitate careful interpretation of results. Manual medical records review is a logical next step to mitigate these shortcomings and allow a more thorough examination of each patient’s course. Nevertheless, we re-analysed our data in response to points raised. The analyses in our original paper suggest an elevated risk of undergoing an esophagogastroduodenoscopy (EGD) in patients treated with glucagon-like peptide-1 receptor agonists (GLP-1 RA) compared with control. As mentioned in our prior reply,2 we recognise that there is a potential diagnostic bias from this observation. We re-ran our cohorts and found that the rate of undergoing an EGD in the propensity-score matched cohort receiving short-acting GLP-1 RA was 6.13% compared with 5.22% in the matched control cohort (OR 1.185; 95% CI 1.131 to 1.241), reflecting the…

Circulation, Volume 150, Issue Suppl_1, Page A4133830-A4133830, November 12, 2024. Introduction:Combination therapy with SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP1RA) reduces major cardiovascular events (MACE) and improves HbA1c, blood pressure, weight, and renal disease progression. The European Society of Cardiology recommends this therapy for ASCVD and T2DM, independent of HbA1c. This study evaluates prescribing patterns in the Internal Medicine Residency Clinics for patients with ASCVD and T2DM.Aims:To investigate demographic and social determinants of health (SDOH) influencing the prescription of combination therapy versus no therapy in an outpatient population and identify factors affecting prescribing patterns and guideline adherence.Methods:We reviewed 828 electronic records of T2DM and ASCVD patients from March 2024. Patients were grouped into combination therapy (SGLT2i and GLP1RA) and no therapy groups. Data on demographics (Table 1) and SDOH (Table 2) were analyzed. Patients on monotherapy or those who did not complete the SDOH questionnaire were excluded. Descriptive statistics were used to summarize demographics. Welch’s t-test compared continuous variables, and chi-square or Fisher’s exact tests compared categorical variables. Analyses were done with SAS 9.4 with significance at 0.05.Results:Age significantly differed between groups (t = 4.56, p < .05), with older patients less likely to receive therapy. Sex was also significant (p < .05); more females were in the no therapy group. No significant association was found between SDOH and combination therapy (p > .05).Conclusion:Over 90% of patients with T2DM and ASCVD were not on optimal medical therapy to reduce MACE, with nearly half on no medications. This highlights the need for increased awareness and targeted interventions to improve outcomes. Future research will explore insurance status and physician awareness to address prescription discrepancies.Limitations:Patients with a GFR

Circulation, Volume 150, Issue Suppl_1, Page A4134267-A4134267, November 12, 2024. Background:The effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium–glucose cotransporter 2 inhibitors (SGLT2is) on reducing cardiovascular events in heart failure patients are well-established; however, less is known about their effects after a myocardial infarction. This study aims to investigate the effects of GLP-1RAs and SGLT2is on in-hospital mortality and 30-day readmission in type 2 diabetic patients with/without heart failure who were hospitalized for acute coronary syndrome (ACS).Methods:We conducted a multicenter retrospective cohort on type 2 diabetic patients who were admitted to the hospital for ACS from 01/01/2020 to 01/31/2024 across 16 West Florida hospitals. Patients receiving a GLP-1RA alone, SGLT2i alone, or both were compared to those taking neither. Chi-square and binary logistic regression were used to predict the clinical outcomes of in-hospital mortality, all-cause readmission within 30 days, and cardiac readmission within 30 days.Results:Among 7,481 type 2 diabetics with ACS, 392 (5.24%) were taking GLP-1RA monotherapy, 577 (7.71%) were taking SGLT2i monotherapy, 144 (1.92%) were taking both, and 6,362 (85.12%) were taking neither. The likelihood of in-hospital mortality was similar among patients on neither medication compared to patients on both (χ2= 0.06,p= 0.802), GLP-1RA monotherapy (χ2= 0.61,p= 0.435), and SGLT2i monotherapy (χ2= 0.002,p= 0.968). The odds of all-cause readmission within 30 days was similar among patients on neither medication compared to patients on both (χ2= 0.0004,p= 0.983), GLP-1RAs monotherapy (χ2= 0.07,p= 0.791), and SGLT2i monotherapy (χ2= 3.10,p= 0.078). The likelihood of cardiac readmission within 30 days was similar among patients on neither medication compared to patients on both medications (χ2= 1.63,p= 0.202), GLP-1RA monotherapy (χ2= 0.95,p= 0.329), and SGLT2i monotherapy (χ2= 0.94,p= 0.332).Conclusion:Our study found no significant differences in the odds of in-hospital mortality or 30-day readmission among type 2 diabetics with ACS who were taking GLP-1RAs, SGLT2is, or both, when compared to those taking neither. These findings further support the outcomes discovered in the EMPACT-MI trial.

Circulation, Volume 150, Issue Suppl_1, Page A4145988-A4145988, November 12, 2024. Introduction:Cardiovascular-kidney-metabolic (CKM) syndrome disproportionately affects individuals with adverse social determinants of health (SDOH). While glucagon-like peptide-1 receptor agonists (GLP-1RAs) improve outcomes in CKM syndrome, inequitable access (e.g., coverage, supply constraints) may worsen health disparities in CKM syndrome.Aims:To characterize the association of individual- and community-level SDOH with GLP-1RA use among Medicare beneficiaries with diabetes.Methods:Cross-sectional study using 100% Medicare claims linked with the Social Vulnerability Index and the US Department of Agriculture Rural-Urban Commuting Area Codes. We evaluated Medicare Advantage and fee-for-service beneficiaries ≥65 years with diabetes enrolled in Part D in 2021 (last year available). Filled prescriptions for GLP-1RAs were identified using National Drug Codes. Baseline characteristics were compared using standardized mean differences. Associations between SDOH (self-identified race and ethnicity, insurance status, social vulnerability index, median household income, rurality, US census region) and GLP-1RA use was evaluated using multivariate logistic regression adjusted for age, sex, and clinical characteristics.Results:Of 13,429,963 adults with diabetes included in the analysis, mean age was 77y and 54.6% were female. During the 1-year study period, 8.5% (475,719) filled ≥1 GLP-1RA prescriptions and were more likely to be younger, have obesity and chronic kidney disease. After adjustment, race and ethnicity were associated with GLP-1 RA use (Compared with non-Hispanic pregnancy: Black race, OR 0.74 (95% CI: 0.73– 0.75); Asian American race, OR 0.80 (0.78– 0.81); Native American, OR, 1.56 (1.50 –1.62); and Hispanic ethnicity 0.91 (0.89–0.93). Medicare Advantage enrollees had lower odds of use than fee-for-service Medicare: OR, 1.18 (1.17 – 1.19). Dual enrollee status, higher median household income, rurality, and higher social vulnerability were associated with greater use.Conclusions:There is substantial variability in the use of GLP-1RAs by individual-level and community-level SDOH factors. Determining the drivers of differential access is urgently needed to enhance equitable use.

Circulation, Volume 150, Issue Suppl_1, Page A4145444-A4145444, November 12, 2024. Introduction:Anthracyclines are associated with cancer therapy-related cardiovascular dysfunction and heart failure (HF). The role of GLP-1 receptor agonists for patients with cancer undergoing anthracycline-based chemotherapy remains unknown.Hypothesis:GLP-1 receptor agonists are associated with reduced mortality and cardiovascular events after chemotherapy with anthracyclines.Aims:Evaluate the association between GLP-1-treated patients undergoing chemotherapy with anthracyclines and mortality and cardiovascular events.Methods:We conducted a retrospective cohort study of de-identified, aggregated data from 120 centers using the TriNetX Global Collaborative Network. Patients with ≥18 years old, a diagnosis of cancer, a history of use of anthracyclines, and either type 2 diabetes mellitus or overweight/obesity were included. We excluded patients with end-stage kidney disease, ischemic heart disease, or aortocoronary bypass graft. Patients were stratified according to treatment with GLP-1 receptor agonists or not and underwent propensity score matching. We compared HF exacerbation, hospitalizations or urgent emergency department visits, and all-cause mortality rates using Cox proportional hazard models over an 8-year follow-up.Results:After propensity score matching, 2,575 patients remained in each cohort. At 8 years, GLP-1 use was associated with significantly lower rates of HF exacerbation, defined as the need for diuretics, pulmonary edema, systolic and/or diastolic acute decompensated HF, or reaching a left ventricular ejection fraction