2209-PUB: Factors Associated with Switching from Sulfonylureas (SUs) to Dipeptidyl Peptidase-4 Inhibitors (DPP-4i) among Individuals with Type 2 Diabetes in the United States
Authors: TAN XI , YANG LINGFENG , KHUNTI KAMLESH , ZHANG RUYA , ZHANG DIANA , RAJPATHAK SWAPNIL , YU MIAO 
Published: June 2020

Background and Objective: Studies examining the prevalence of and factors associated with switching from sulfonylureas (SUs) to dipeptidyl peptidase 4 inhibitors (DPP-4i) in real-world settings are lacking. We assessed the factors associated with switching from SUs to DPP-4i in the United States (U.S.).
Methods: The retrospective cohort study was conducted using the U.S. Clinformatics® Data Mart (2009-2018). Adults with type 2 diabetes (T2D) and newly prescribed at least two SU prescriptions were included. Eligible individuals were followed for two years after the initiation of SU. We compare individuals’ characteristics between those who switched from SUs to DPP-4i and those who continued with SUs without adding other antidiabetic drugs.
Results: In the total of 119,107 new SU users, 74.4% discontinued SUs within two years while 25.6% continued with SUs. Among those who discontinued with SUs, 4.7% switched to DPP-4i, and 12.6% switched to other antidiabetic drugs. Additionally, in those who continued with SUs, about 49.8% did not add other antidiabetic drugs. Multivariate logistic regression showed that those who had higher likelihood of switching were younger, female, living in the South, prior use of DPP-4i, fewer antidiabetic drugs used before the initiation of SU, glyburide user (vs. glimepiride user), and with cardiovascular disease or depression.
Conclusion: The discontinuation rate for SUs is high (74.4%). Factors associated with switching from SUs to DPP-4i may help providers make more informed treatment decisions or develop strategies based on different individuals’ characteristics to improve medication use.

Disclosure
X. Tan: Employee; Self; Merck & Co., Inc. Stock/Shareholder; Self; Merck & Co., Inc. L. Yang: Employee; Self; Merck & Co., Inc. K. Khunti: Advisory Panel; Self; Amgen, AstraZeneca, Bayer AG, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Menarini Group, Merck Sharp & Dohme Corp., Napp Pharmaceuticals, Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi-Aventis, Servier. Board Member; Self; AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi-Aventis. Consultant; Self; Amgen, AstraZeneca, Bayer AG, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Menarini Group, Merck Sharp & Dohme Corp., Napp Pharmaceuticals, Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi-Aventis, Servier. Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis, Servier. Speaker’s Bureau; Self; Amgen, AstraZeneca, Bayer AG, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Menarini Group, Merck Sharp & Dohme Corp., Napp Pharmaceuticals, Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi-Aventis, Servier. R. Zhang: Employee; Self; Merck Sharp & Dohme Corp. D. Zhang: Employee; Self; Merck Sharp & Dohme Corp. S. Rajpathak: Employee; Self; Menarini Group. M. Yu: None.

Funding
Merck Sharp & Dohme Corp; Pfizer Inc.