Persistence with statin therapy lags behind persistence with an oral antihyperglycemic regimen in type 2 diabetic patients simultaneously prescribed treatment with statins and oral antihyperglycemic agents, researchers announced at the American Heart Association (AHA) Scientific Sessions 2010.

“Integrated approaches for minimizing the persistence gap might potentially reduce cardiovascular risks in this population,” Qiaoyi Zhang, MD, PhD, who is Associate Director with Global Health Outcomes at Merck Sharp & Dohme Corporation in Whitehouse Station, New Jersey, said.

Dr. Zhang and her associates used a U.S. commercial claims database to compare the persistence between statin and oral antihyperglycemic therapy use in type 2 diabetics who were dispensed both a statin and oral antihyperglycemic agent on the same date. The first date in 2006 of such dispensing was considered the index date.

Based on treatment guidelines, statin therapy is recommended for almost all type 2 diabetics in order to reduce their elevated cardiovascular risk.

Persistence with both antihyperglycemic and statin therapies is requisite in order to obtain the long-term clinical benefits on glycemic control and cardiovascular outcomes.

The analysis included 52,414 patients whose medical records were evaluated for one year prior to and for two years after the index date. Statin therapy and the oral antihyperglycemic regimen were assessed as two separate entities. The two-year medication possession ratio (MPR) was compared between statin and the oral antihyperglycemic therapy.

The investigators reported that fewer patients were persistent with their statin therapy (28%) than with their oral antihyperglycemic agent (41%) over the two-year period, with a shorter median time to discontinuation and a lower MPR for statin therapy.

Statin therapy was more likely to be discontinued during follow-up than oral antihyperglycemic therapy.

Younger patients (˂65 years) were more likely to stop therapy prematurely than older patients (65+ years).

Also, patients from urban areas and those with pre-existing heart failure were more likely to discontinue therapy. Males, patients with health maintenance organization (HN) and preferred provider organization (PPO) insurance plans, and those with pre-existing microvascular conditions were less likely to discontinue therapy.

“These data suggest the need for effective and simultaneous treatment for two related conditions, cardiovascular disease and diabetes,” Dr. Zhang said.

Funding for the study was provided by Merck Sharp & Dohme Corporation.

Written by Jill Stein
Jill Stein is a Paris-based freelance medical writer.