FRI090 Patterns Of Triglyceride Testing And Results Over Time Among Patients With Diabetes And Severe Hypertriglyceridemia In US Clinical Practice
Authors: Kutrieb Emily , Baum Seth J , Dukes Ellen , Sikora Kessler Asia , Weycker Derek , Vera Llonch Montserrat , Respress Jonathan , Soffer Daniel 
Published: October 2023

Abstract
Disclosure: E. Kutrieb: Consulting Fee; Self; Ionis Pharmaceuticals Inc. S.J. Baum: Advisory Board Member; Self; Altimmune, Amgen Inc, Axcella, Boehringer Ingelheim, Eli Lilly & Company, Esperion, Madrigal Pharmaceuticals, Novartis Pharmaceuticals, Regeneron Pharmaceuticals. Consulting Fee; Self; Altimmune, Amgen Inc, Ionis Pharmaceuticals Inc., Madrigal Pharmaceuticals, Merck, Novartis Pharmaceuticals, Regeneron Pharmaceuticals. Speaker; Self; Amgen Inc, Boehringer Ingelheim, Esperion, Eli Lilly & Company, Regeneron Pharmaceuticals. Other; Self; Madrigal Pharmaceuticals. E. Dukes: Consulting Fee; Self; Ionis Pharmaceuticals Inc. A. Sikora Kessler: Employee; Self; Ionis Pharmaceuticals Inc. D. Weycker: Consulting Fee; Self; Ionis Pharmaceuticals Inc. M. Vera Llonch: Employee; Self; Ionis Pharmaceuticals Inc. J. Respress: Employee; Self; Ionis Pharmaceuticals Inc. D. Soffer: Consulting Fee; Self; Akcea Therapeutics, Amgen Inc, Ionis Pharmaceuticals Inc., Kaneka, Novartis Pharmaceuticals. Research Investigator; Self; Akcea Therapeutics, Amgen Inc, Amryt, AstraZeneca, Ionis Pharmaceuticals Inc., Novartis Pharmaceuticals, Regeneron Pharmaceuticals, RegenXBio.
Introduction: Evidence on patterns of triglyceride (TG) testing and test results among patients with diabetes in US clinical practice, especially those with severe hypertriglyceridemia (SHTG, defined as TG ≥1000 mg/dL), is sparse. We undertook a real-world study to address this evidence gap. Methodology: A retrospective observational cohort design and data from the Merative Linked MarketScan-Labs Database (01/01/13-12/31/19) were employed. Study population included patients with diabetes and ≥1 TG value, stratified by first TG value (&lt;500, 500-999, ≥1000 mg/dL); for selected analyses, patients were limited to those with multiple TG values. Study measures were assessed beginning with the first TG value and included: number of TG tests (all patients), days between tests (patients with ≥2 TG values), TG values by test (all patients), and TG values across tests (patients with ≥3 TG values receiving statins only or TG-targeting therapy only [fenofibrate, fenofibric acid, icosapent ethyl, gemibrozil, omega-3 fatty acid]). Study measures were summarized using means (standard deviations [SD]) and percentages. Results: Among 465,034 patients with diabetes in the study population, 0.5% (N=2,247) were classified as having SHTG (TG ≥1000 mg/dL) based on their first value. Mean age of SHTG patients was 49 years, 75% were male, and 52% had a recent history (ie, within 12 months) of lipid-lowering therapy (statins: 38%; fenofibrate: 21%). Mean value for first TG was 1,924 mg/dL, and most patients (75%) had ≤3 TG values (1: 39%; 2: 23%; 3: 13%) during a mean follow-up of 22 (SD=21) months. Among patients with ≥2 TG values (N=1,366), mean interval between first and second TG values was 221 (SD=267) days; days between subsequent TG values were comparable to the first interval. Among SHTG patients with ≥3 TG values receiving only statin therapy (N=163), the second TG value was &lt;500 mg/dL for 45%, 500-999 mg/dL for 21%, and ≥1000 mg/dL for 34%; all 3 TG values were ≥1000 mg/dL for 16% of patients. Among SHTG patients with ≥3 TG values receiving only TG-targeting therapy (N=121), the second TG value was &lt;500 mg/dL for 30%, 500-999 mg/dL for 44%, and ≥1000 mg/dL for 26%; all 3 TG values were ≥1000 mg/dL for 12% of patients. Among patients with lower initial TG values (&lt;500: N=453,940; 500-999: N=8,847), TG testing patterns were largely comparable to those among SHTG patients. Conclusions: TG testing among patients with diabetes and SHTG is relatively infrequent in US clinical practice, and test results are highly variable. Understanding these patterns is important for identifying, testing, and treating patients with diabetes and SHTG to reduce health risks.
Presentation: Friday, June 16, 2023