7265 Characterization of Treatment Intensified (Add-on To Metformin) Adults With Type 2 Diabetes Mellitus In Thailand: A cross sectional real-world study (CONVERGE)
Authors: Sriphrapradang Chutintorn , Chinthammit Ratiporn , Nayak Gurudutt 
Published: October 2024

Abstract
Disclosure: C. Sriphrapradang: Research Investigator; Self; Novo Nordisk. Speaker; Self; AstraZeneca, Bayer, Inc., Boehringer Ingelheim, Eli Lilly & Company, Novo Nordisk. R. Chinthammit: Employee; Self; 2.Novo Nordisk Pharma Thailand Ltd. G. Nayak: Employee; Self; Novo Nordisk Pharma Thailand Ltd.
Background: Globally, 1 in 3 people with type 2 diabetes (T2D) have established cardiovascular disease (CVD), but only 2 in 10 receive antidiabetic agents (ADA) (members of glucagon-like peptide-1 receptor agonist [GLP-1RAs] and sodium-glucose co-transporter-2 inhibitors [SGLT-2is]) with proven CV benefits. Guidelines recommend a holistic approach to managing glycemic control and CVD risk. Understanding clinical characteristics and medication patterns in people with T2D in a local setting could help address the unmet needs in T2D management. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real World with GLP-1RAs) study in three Asian countries (India, Pakistan, Thailand) involves two phases. Phase 1 characterizes eligible adults with T2D intensified on metformin (add-on to metformin) regarding demographics, clinical parameters, and medication patterns. Here we report findings from Thailand. Methods: Due to healthcare differences, a mosaic approach was used for the retrospective cross-sectional data collection based on medical record reviews. For Thailand, electronic medical record (EMR) data of eligible adults (≥18 years old) with T2D from December 12, 2008 (on or post-market approval of GLP-1RAs [start of medical record]) to December 31, 2017. Data were collected at start of medical record and at 6 or 12 months prior to baseline based on variable type. Results: Due to descriptive nature of the study, no formal sample size calculation was performed. Data from 1,000 adults were collected in reverse chronological order as the EMR held a larger pool of eligible patients. At baseline, the mean (SD) age was 60 (12) years, HbA1c was 8.0%, and the median (IQR) T2D duration was 1.0 (0.2-2.4) years. Metformin (81%), sulfonylureas (45%), and dipeptidyl peptidase-4 inhibitors (39%) were frequently prescribed. Among the subgroups, patients taking SGLT-2is had a longer T2D duration, those on GLP-1RA had a higher body mass index, and those in the insulin group had a higher HbA1c. Overall, 86% received ≥1 ADAs, with most (80%) patients from the GLP-1RA subgroup received 3/≥4 ADAs before baseline compared to other subgroups. Overall, 90% received ≥1 CVD medication, while most (70%) patients in the GLP-1RA subgroup received 3/≥4 CVD medications than other subgroups. Metformin (81%) and lipid-lowering agents (78%) were the most prescribed ADA and CVD medications, respectively. The utilization of ADAs with CV benefits was low (GLP-1RA, 1.5%; SGLT-2is, 6%). Conclusion: These results indicate low ADA utilization with CV benefits, which may be attributed to the study period when no CV benefit data was available for GLP-1RA/SGLT-2is and to partial implementation of reimbursement policy. As more evidence becomes available on positive CV outcomes, future studies are required to estimate the ADA usage with CV benefits in Thailand.
Presentation: 6/1/2024