- Diabetes, obesity and metabolism
- Financial Benefits of Renal Dose-Adjusted Dipeptidyl Peptidase-4 Inhibitors for Patients with Type 2 Diabetes and Chronic Kidney Disease
-
Hun Jee Choe, Yeh-Hee Ko, Sun Joon Moon, Chang Ho Ahn, Kyoung Hwa Ha, Hyeongsuk Lee, Jae Hyun Bae, Hyung Joon Joo, Hyejin Lee, Jang Wook Son, Dae Jung Kim, Sin Gon Kim, Kwangsoo Kim, Young Min Cho
-
Endocrinol Metab. 2024;39(4):622-631. Published online August 1, 2024
-
DOI: https://doi.org/10.3803/EnM.2024.1965
-
-
 Abstract
 PDF Supplementary Material PubReader  ePub
- Background
Dipeptidyl peptidase-4 (DPP4) inhibitors are frequently prescribed for patients with type 2 diabetes; however, their cost can pose a significant barrier for those with impaired kidney function. This study aimed to estimate the economic benefits of substituting non-renal dose-adjusted (NRDA) DPP4 inhibitors with renal dose-adjusted (RDA) DPP4 inhibitors in patients with both impaired kidney function and type 2 diabetes.
Methods
This retrospective cohort study was conducted from January 1, 2012 to December 31, 2018, using data obtained from common data models of five medical centers in Korea. Model 1 applied the prescription pattern of participants with preserved kidney function to those with impaired kidney function. In contrast, model 2 replaced all NRDA DPP4 inhibitors with RDA DPP4 inhibitors, adjusting the doses of RDA DPP4 inhibitors based on individual kidney function. The primary outcome was the cost difference between the two models.
Results
In total, 67,964,996 prescription records were analyzed. NRDA DPP4 inhibitors were more frequently prescribed to patients with impaired kidney function than in those with preserved kidney function (25.7%, 51.3%, 64.3%, and 71.6% in patients with estimated glomerular filtration rates [eGFRs] of ≥60, <60, <45, and <30 mL/min/1.73 m2, respectively). When model 1 was applied, the cost savings per year were 7.6% for eGFR <60 mL/min/1.73 m2 and 30.4% for eGFR <30 mL/min/1.73 m2. According to model 2, 15.4% to 51.2% per year could be saved depending on kidney impairment severity.
Conclusion
Adjusting the doses of RDA DPP4 inhibitors based on individual kidney function could alleviate the economic burden associated with medical expenses.
- Diabetes
- Peptidyl and Non-Peptidyl Oral Glucagon-Like Peptide-1 Receptor Agonists
-
Hun Jee Choe, Young Min Cho
-
Endocrinol Metab. 2021;36(1):22-29. Published online February 24, 2021
-
DOI: https://doi.org/10.3803/EnM.2021.102
-
-
29,424
View
-
705
Download
-
17
Web of Science
-
18
Crossref
-
Abstract
PDFPubReader ePub
- Glucagon-like peptide-1 (GLP-1) receptor agonists are efficacious glucose-lowering medications with salient benefits for body weight and cardiovascular events. This class of medications is now recommended as the top priority for patients with established cardiovascular disease or indicators of high risk. Until the advent of oral semaglutide, however, GLP-1 receptor agonists were available only in the form of subcutaneous injections. Aversion to needles, discomfort with self-injection, or skin problems at the injection site are commonly voiced problems in people with diabetes, and thus, attempts for non-invasive delivery strategies have continued. Herein, we review the evolution of GLP-1 therapy from its discovery and the development of currently approved drugs to the unprecedented endeavor to administer GLP-1 receptor agonists via the oral route. We focus on the pharmacokinetic and pharmacodynamic properties of the recently approved oral GLP-1 receptor agonist, oral semaglutide. Small molecule oral GLP-1 receptor agonists are currently in development, and we introduce how these chemicals have addressed the challenge posed by interactions with the large extracellular ligand binding domain of the GLP-1 receptor. We specifically discuss the structure and pharmacological properties of TT-OAD2, LY3502970, and PF-06882961, and envision an era where more patients could benefit from oral GLP-1 receptor agonist therapy.
-
Citations
Citations to this article as recorded by  - Sulfobetaine modification of poly (D, L-lactide-co-glycolic acid) nanoparticles enhances mucus permeability and improves bioavailability of orally delivered liraglutide
Zhenyu Zhao, Ruihuan Ding, Yumei Wang, Ranran Yuan, Houqian Zhang, Tianyang Li, Wei Zheng, Entao Chen, Aiping Wang, Yanan Shi
Journal of Drug Delivery Science and Technology.2024; 93: 105437. CrossRef - Physiology and pharmacology of glucagon-like peptide-1 receptor
D. V. Kurkin, D. A. Bakulin, E. I. Morkovin, V. I. Petrov, A. V. Strygin, K. N. Koryanova, Yu. V. Gorbunova, Yu. A. Kolosov, O. V. Ivanova, E. V. Pavlova, M. A. Dzhavakhyan, A. V. Zaborovsky, V. B. Saparova, I. E. Makarenko, R. I. Drai, A. N. Chumachenko
Pharmacy & Pharmacology.2024; 11(4): 347. CrossRef - G protein-coupled receptors driven intestinal glucagon-like peptide-1 reprogramming for obesity: Hope or hype?
Mohan Patil, Ilaria Casari, Leon N. Warne, Marco Falasca
Biomedicine & Pharmacotherapy.2024; 172: 116245. CrossRef - Glucagon-like peptide-1 analogs: Miracle drugs are blooming?
Binbin Gong, Zhihong Yao, Chenxu Zhou, Wenxi Wang, Lidan Sun, Jing Han
European Journal of Medicinal Chemistry.2024; 269: 116342. CrossRef - The Discovery and Development of Glucagon-Like Peptide-1
Receptor Agonists
Haowen Fang, Bing Niu, Qin Chen
Current Medicinal Chemistry.2024; 31(20): 2921. CrossRef - Binding sites and design strategies for small molecule GLP-1R agonists
Haibo Zhang, Tianxiao Wu, Yong Wu, Yuran Peng, Xian Wei, Tao Lu, Yu Jiao
European Journal of Medicinal Chemistry.2024; 275: 116632. CrossRef - Advances in small-molecule insulin secretagogues for diabetes treatment
Jingqian Su, Jingran Xu, Shan Hu, Hui Ye, Lian Xie, Songying Ouyang
Biomedicine & Pharmacotherapy.2024; 178: 117179. CrossRef - Peptide GLP-1 receptor agonists: From injection to oral delivery strategies
Zhiqiang Ke, Qianqian Ma, Xiaonan Ye, Yanlin Wang, Yan Jin, Xinyuan Zhao, Zhengding Su
Biochemical Pharmacology.2024; 229: 116471. CrossRef - Design and Evaluation of 3-Phenyloxetane Derivative Agonists of the Glucagon-Like Peptide-1 Receptor
Zhimin Zhang, Hao Pan, Liubin Guo, Cancan Cai, Tingni Chen, Zhiping Zhang, Xu Yang, Haowen Zheng, Chunhua Jiang, Zhiyong Wang, Yacheng Yang, Zhe Wang, Xiaohua Zhang, Yuchen Zhang, Dongzhou Liu
Journal of Medicinal Chemistry.2024; 67(17): 14820. CrossRef - Opportunities and challenges of incretin-based hypoglycemic agents treating type 2 diabetes mellitus from the perspective of physiological disposition
Yaochen Xie, Qian Zhou, Qiaojun He, Xiaoyi Wang, Jincheng Wang
Acta Pharmaceutica Sinica B.2023; 13(6): 2383. CrossRef - Advances in GLP-1 receptor agonists for the treatment of type 2 diabetes
Shurui Hong, J. Xiao, Y. He
BIO Web of Conferences.2023; 61: 01006. CrossRef - Safety and efficacy of the new, oral, small-molecule, GLP-1 receptor agonists orforglipron and danuglipron for the treatment of type 2 diabetes and obesity: systematic review and meta-analysis of randomized controlled trials
Paschalis Karakasis, Dimitrios Patoulias, Konstantinos Pamporis, Panagiotis Stachteas, Konstantinos I. Bougioukas, Aleksandra Klisic, Nikolaos Fragakis, Manfredi Rizzo
Metabolism.2023; 149: 155710. CrossRef - A review of glucoregulatory hormones potentially applicable to the treatment of Alzheimer’s disease: mechanism and brain delivery
Reeju Amatya, Kyoung Ah Min, Meong Cheol Shin
Journal of Pharmaceutical Investigation.2022; 52(2): 195. CrossRef - Anti-Obesity Medications and Investigational Agents: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022
Harold E. Bays, Angela Fitch, Sandra Christensen, Karli Burridge, Justin Tondt
Obesity Pillars.2022; 2: 100018. CrossRef - Structural basis of peptidomimetic agonism revealed by small-molecule GLP-1R agonists Boc5 and WB4-24
Zhaotong Cong, Qingtong Zhou, Yang Li, Li-Nan Chen, Zi-Chen Zhang, Anyi Liang, Qing Liu, Xiaoyan Wu, Antao Dai, Tian Xia, Wei Wu, Yan Zhang, Dehua Yang, Ming-Wei Wang
Proceedings of the National Academy of Sciences.2022;[Epub] CrossRef - Improved Split TEV GPCR β-arrestin-2 Recruitment Assays via Systematic Analysis of Signal Peptide and β-arrestin Binding Motif Variants
Yuxin Wu, Isabelle von Hauff, Niels Jensen, Moritz Rossner, Michael Wehr
Biosensors.2022; 13(1): 48. CrossRef - GLP-1 Receptor Agonists: Beyond Their Pancreatic Effects
Xin Zhao, Minghe Wang, Zhitong Wen, Zhihong Lu, Lijuan Cui, Chao Fu, Huan Xue, Yunfeng Liu, Yi Zhang
Frontiers in Endocrinology.2021;[Epub] CrossRef - Recent developments in GLP‐1RA therapy: A review of the latest evidence of efficacy and safety and differences within the class
Evie K. Bain, Stephen C. Bain
Diabetes, Obesity and Metabolism.2021; 23(S3): 30. CrossRef
|
KES
