Healthcare resource utilization in patients treated with empagliflozin in East Asia.

AIMS/INTRODUCTION: We investigated the utilization of healthcare resources in patients with type 2 diabetes treated with empagliflozin, a sodium-glucose co-transporter-2 (SGLT2) inhibitor, versus dipeptidyl peptidase-4 (DPP-4) inhibitors in clinical practice in Japan, South Korea, and Taiwan. MATERIALS AND METHODS: We analyzed the Japanese Medical Data Vision database (December 2014-April 2018), the South Korean National Health Information Database, and the Taiwanese National Health Insurance claims database (both May 2016-December 2017). Patients with type 2 diabetes starting empagliflozin, 10 or 25 mg, or a DPP-4 inhibitor were matched 1:1 via propensity scores (PS). We compared inpatient care needs, emergency room (ER) visits, and outpatient visits between the treatment groups using Poisson regression and Cox proportional hazards models, pooled across countries by random-effects meta-analysis. RESULTS: We identified 28,712 pairs of PS-matched patients; the mean follow-up was 5.7-6.8 months. Empagliflozin-treated patients had a 27% lower risk of all-cause hospitalization compared with DPP-4 inhibitor-treated patients (rate ratio [RR] 0.73, 95% CI 0.67-0.79), and 23% reduced risk for first hospitalization (hazard ratio 0.77, 95% CI 0.73-0.81). The risk for an ER visit was 12% lower with empagliflozin than with DPP-4 inhibitors (RR 0.88, 95% CI 0.83-0.94) while the risk for outpatient visit was 4% lower (RR 0.96, 95% CI 0.96-0.97). These findings were generally consistent across countries, regardless of baseline cardiovascular disease, and in the subgroup starting empagliflozin with the 10 mg dose. CONCLUSIONS: Empagliflozin treatment was associated with lower inpatient care needs and other healthcare resource utilization than DPP-4 inhibitors in routine clinical practice in East Asia in this study.

Cardiovascular and renal effectiveness of empagliflozin in routine care in East Asia: Results from the EMPRISE East Asia study.

Aim: To evaluate the effectiveness of empagliflozin in clinical practice in East Asia in the Empagliflozin Comparative Effectiveness and Safety (EMPRISE) East Asia study. Materials and methods: Data were obtained from the Medical Data Vision database (Japan), National Health Insurance Service database (South Korea) and National Health Insurance database (Taiwan). Patients aged ≥ 18 years with type 2 diabetes initiating empagliflozin or a dipeptidyl peptidase-4 (DPP-4) inhibitor were 1:1 propensity score (PS) matched into sequentially built cohorts of new users naïve to both drug classes. This design reduces confounding due to switching treatments, time lag and immortal time biases. Outcomes included hospitalization for heart failure (HHF), end-stage renal disease (ESRD) and all-cause mortality. Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional models, controlling for > 130 baseline characteristics in each data source and pooled by random-effects meta-analysis. Results: Overall, 28 712 pairs of PS-matched patients were identified with mean follow-up of 5.7-6.8 months. Compared with DPP-4 inhibitors, the risk of HHF was reduced by 18% and all-cause mortality was reduced by 36% with empagliflozin (HR 0.82; 95% CI 0.71-0.94, and HR 0.64; 95% CI 0.50-0.81, respectively). Reductions were consistent across countries, and in patients with and without baseline cardiovascular disease. ESRD was also significantly reduced with empagliflozin versus DPP-4 inhibitors (HR 0.37; 95% CI 0.24-0.58). Conclusions: Empagliflozin treatment was associated with reduced risk for HHF, all-cause mortality and ESRD compared with DPP-4 inhibitors in routine clinical practice in Japan, South Korea and Taiwan.

A survey of allergic rhinitis in Taiwanese asthma patients.

BACKGROUND: Allergic rhinitis (AR) often coexists with and can significantly worsen bronchial asthma (BA). We evaluated the proportion of patients with BA and concomitant AR (BA+AR) diagnosed and treated in an average clinical practice. METHODS: A cross-sectional study methodology was used to determine the prevalence of AR in patients more than 15 years of age with a documented history of asthma who experienced wheezing during the prior 12 months. The International Study of Asthma and Allergies in Childhood standardized written questionnaire was used and therapeutic class choices were recorded. RESULTS: Among 750 surveyed asthma patients, 524 patients (69.9%) experienced AR. Of those with BA and AR, there were 44 patients (8.4%) who were not diagnosed with AR, and the treatment rate for AR was 62.1%. The most frequent severity level of BA and AR were moderate persistent (38.9%) and intermittent mild (52.5%), respectively. There were no significant differences between patients with AR and without AR. CONCLUSIONS: The prevalence of AR in patients with asthma was 69.9% in this study. Despite Allergic Rhinitis and its Impact on Asthma guideline recommendations encouraging evaluation and treatment of AR among asthmatics, nearly 8.4% of asthmatics with AR were undiagnosed, and 37.9% of asthmatics with AR were untreated for AR.