1199-P: Analysis of Patient Preferences for Adjunct Therapy to Insulin in T1D
Recent ADA/EASD recommendations emphasize the importance of the patient role in therapy decisions. Adjunct to insulin SGLT inhibitor (SGLTi) therapy for T1D has been evaluated in RCTs but patient reaction to the benefit-risk profile of these agents is unknown. We aimed to objectively evaluate patien...
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| Veröffentlicht in: | Diabetes (New York, N.Y.) N.Y.), 2019-06, Vol.68 (Supplement_1) |
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| creator | PERKINS, BRUCE A. ROSENSTOCK, JULIO SKYLER, JAY S. LAFFEL, LORI M. CHERNEY, DAVID MATHIEU, CHANTAL PANG, CHRISTIANNE WOOD, RICHARD KINDURYTE, ONA GEORGE, JYOTHIS MARQUARD, JAN SOLEYMANLOU, NIMA |
| description | Recent ADA/EASD recommendations emphasize the importance of the patient role in therapy decisions. Adjunct to insulin SGLT inhibitor (SGLTi) therapy for T1D has been evaluated in RCTs but patient reaction to the benefit-risk profile of these agents is unknown. We aimed to objectively evaluate patient preferences for different therapy options, using a Discrete Choice Experiment (DCE) form of conjoint analysis, a validated methodology. The DCE used an online survey, completed by 701 respondents with T1D (231 U.S., 242 Canada, 228 Germany), to present 6 hypothetical, masked pair-wise drug profile comparison choices composed of different benefit-risk attributes and clinical effect ranges (levels). Attributes and levels were derived from different combinations of phase 3 trial data for a low dose SGLTi (comparable to empagliflozin 2.5mg); a high dose SGLTi (comparable to sotagliflozin 400mg); and an available adjunct to insulin therapy (pramlintide 60µg TID). Based upon respondents’ choices, DCE calculated, in %, the relative importance of one attribute to another and the overall predicted therapy preferences. DKA risk was the most important attribute with a relative importance of 23% (z-test, p |
| doi_str_mv | 10.2337/db19-1199-P |
| format | Article |
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In conclusion, the DCE and head-to-head explicit choice identified low dose SGLTi as the favored patient preference for adjunct therapy to insulin in T1D.</description><identifier>ISSN: 0012-1797</identifier><identifier>EISSN: 1939-327X</identifier><identifier>DOI: 10.2337/db19-1199-P</identifier><language>eng</language><publisher>New York: American Diabetes Association</publisher><subject>Diarrhea ; Drug dosages ; Hypoglycemia ; Insulin ; Nausea ; Patients ; Preferences</subject><ispartof>Diabetes (New York, N.Y.), 2019-06, Vol.68 (Supplement_1)</ispartof><rights>Copyright American Diabetes Association Jun 1, 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids></links><search><creatorcontrib>PERKINS, BRUCE A.</creatorcontrib><creatorcontrib>ROSENSTOCK, JULIO</creatorcontrib><creatorcontrib>SKYLER, JAY S.</creatorcontrib><creatorcontrib>LAFFEL, LORI M.</creatorcontrib><creatorcontrib>CHERNEY, DAVID</creatorcontrib><creatorcontrib>MATHIEU, CHANTAL</creatorcontrib><creatorcontrib>PANG, CHRISTIANNE</creatorcontrib><creatorcontrib>WOOD, RICHARD</creatorcontrib><creatorcontrib>KINDURYTE, ONA</creatorcontrib><creatorcontrib>GEORGE, JYOTHIS</creatorcontrib><creatorcontrib>MARQUARD, JAN</creatorcontrib><creatorcontrib>SOLEYMANLOU, NIMA</creatorcontrib><title>1199-P: Analysis of Patient Preferences for Adjunct Therapy to Insulin in T1D</title><title>Diabetes (New York, N.Y.)</title><description>Recent ADA/EASD recommendations emphasize the importance of the patient role in therapy decisions. Adjunct to insulin SGLT inhibitor (SGLTi) therapy for T1D has been evaluated in RCTs but patient reaction to the benefit-risk profile of these agents is unknown. We aimed to objectively evaluate patient preferences for different therapy options, using a Discrete Choice Experiment (DCE) form of conjoint analysis, a validated methodology. The DCE used an online survey, completed by 701 respondents with T1D (231 U.S., 242 Canada, 228 Germany), to present 6 hypothetical, masked pair-wise drug profile comparison choices composed of different benefit-risk attributes and clinical effect ranges (levels). Attributes and levels were derived from different combinations of phase 3 trial data for a low dose SGLTi (comparable to empagliflozin 2.5mg); a high dose SGLTi (comparable to sotagliflozin 400mg); and an available adjunct to insulin therapy (pramlintide 60µg TID). Based upon respondents’ choices, DCE calculated, in %, the relative importance of one attribute to another and the overall predicted therapy preferences. DKA risk was the most important attribute with a relative importance of 23% (z-test, p<0.05). Second and similarly important were HbA1c reduction (14%), risk of hypoglycemia (13%), oral vs. injection treatment (13%), and risk of genital infection (12%). Next was risk of nausea (11%); weight reduction (8%) and risk of diarrhea (7%) were least important. The predicted therapy preference share was highest for low dose SGLTi, ranked first by 83% (z-test, p<0.05), compared with 8% for high dose SGLTi and 9% for pramlintide. In a separate question, respondents were asked to explicitly choose (masked to drug profile name and dose) among the clinical trial profiles of low dose SGLTi (chosen by 69%), high dose SGLTi (17%), pramlintide (6%), and ‘none of the above’ (9%).
In conclusion, the DCE and head-to-head explicit choice identified low dose SGLTi as the favored patient preference for adjunct therapy to insulin in T1D.</description><subject>Diarrhea</subject><subject>Drug dosages</subject><subject>Hypoglycemia</subject><subject>Insulin</subject><subject>Nausea</subject><subject>Patients</subject><subject>Preferences</subject><issn>0012-1797</issn><issn>1939-327X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNotkE1LxDAURYMoOI6u_AMBlxJN8tI2z10ZvwZG7KILdyFtE-xQ25q0i_n3dhi5D-7m8OAeQm4Ff5AA2WNTCWRCILLijKwEAjKQ2dc5WXEuJBMZZpfkKsY95zxdsiIfJ_qJ5r3tDrGNdPC0sFPr-okWwXkXXF-7SP0QaN7s576eaPntgh0PdBroto9z1_Z0uVI8X5MLb7vobv57TcrXl3Lzznafb9tNvmN1qpA1mnP0ukblFGqVqUpjprhEVKCc9QqaqhJJnXIQyoKGpELpXaNTaCCxAGtyd3o7huF3dnEy-2EOy4BopFQaUOsEF-r-RNVhiHGZYsbQ_thwMIKboy5z1GWOAkwBf5_JWio</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>PERKINS, BRUCE A.</creator><creator>ROSENSTOCK, JULIO</creator><creator>SKYLER, JAY S.</creator><creator>LAFFEL, LORI M.</creator><creator>CHERNEY, DAVID</creator><creator>MATHIEU, CHANTAL</creator><creator>PANG, CHRISTIANNE</creator><creator>WOOD, RICHARD</creator><creator>KINDURYTE, ONA</creator><creator>GEORGE, JYOTHIS</creator><creator>MARQUARD, JAN</creator><creator>SOLEYMANLOU, NIMA</creator><general>American Diabetes Association</general><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>20190601</creationdate><title>1199-P: Analysis of Patient Preferences for Adjunct Therapy to Insulin in T1D</title><author>PERKINS, BRUCE A. ; ROSENSTOCK, JULIO ; SKYLER, JAY S. ; LAFFEL, LORI M. ; CHERNEY, DAVID ; MATHIEU, CHANTAL ; PANG, CHRISTIANNE ; WOOD, RICHARD ; KINDURYTE, ONA ; GEORGE, JYOTHIS ; MARQUARD, JAN ; SOLEYMANLOU, NIMA</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c649-d8009f8c94e498474b89740299434eaf43dbb15c60314a3835b92fed863d35a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Diarrhea</topic><topic>Drug dosages</topic><topic>Hypoglycemia</topic><topic>Insulin</topic><topic>Nausea</topic><topic>Patients</topic><topic>Preferences</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>PERKINS, BRUCE A.</creatorcontrib><creatorcontrib>ROSENSTOCK, JULIO</creatorcontrib><creatorcontrib>SKYLER, JAY S.</creatorcontrib><creatorcontrib>LAFFEL, LORI M.</creatorcontrib><creatorcontrib>CHERNEY, DAVID</creatorcontrib><creatorcontrib>MATHIEU, CHANTAL</creatorcontrib><creatorcontrib>PANG, CHRISTIANNE</creatorcontrib><creatorcontrib>WOOD, RICHARD</creatorcontrib><creatorcontrib>KINDURYTE, ONA</creatorcontrib><creatorcontrib>GEORGE, JYOTHIS</creatorcontrib><creatorcontrib>MARQUARD, JAN</creatorcontrib><creatorcontrib>SOLEYMANLOU, NIMA</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Diabetes (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>PERKINS, BRUCE A.</au><au>ROSENSTOCK, JULIO</au><au>SKYLER, JAY S.</au><au>LAFFEL, LORI M.</au><au>CHERNEY, DAVID</au><au>MATHIEU, CHANTAL</au><au>PANG, CHRISTIANNE</au><au>WOOD, RICHARD</au><au>KINDURYTE, ONA</au><au>GEORGE, JYOTHIS</au><au>MARQUARD, JAN</au><au>SOLEYMANLOU, NIMA</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>1199-P: Analysis of Patient Preferences for Adjunct Therapy to Insulin in T1D</atitle><jtitle>Diabetes (New York, N.Y.)</jtitle><date>2019-06-01</date><risdate>2019</risdate><volume>68</volume><issue>Supplement_1</issue><issn>0012-1797</issn><eissn>1939-327X</eissn><abstract>Recent ADA/EASD recommendations emphasize the importance of the patient role in therapy decisions. Adjunct to insulin SGLT inhibitor (SGLTi) therapy for T1D has been evaluated in RCTs but patient reaction to the benefit-risk profile of these agents is unknown. We aimed to objectively evaluate patient preferences for different therapy options, using a Discrete Choice Experiment (DCE) form of conjoint analysis, a validated methodology. The DCE used an online survey, completed by 701 respondents with T1D (231 U.S., 242 Canada, 228 Germany), to present 6 hypothetical, masked pair-wise drug profile comparison choices composed of different benefit-risk attributes and clinical effect ranges (levels). Attributes and levels were derived from different combinations of phase 3 trial data for a low dose SGLTi (comparable to empagliflozin 2.5mg); a high dose SGLTi (comparable to sotagliflozin 400mg); and an available adjunct to insulin therapy (pramlintide 60µg TID). Based upon respondents’ choices, DCE calculated, in %, the relative importance of one attribute to another and the overall predicted therapy preferences. DKA risk was the most important attribute with a relative importance of 23% (z-test, p<0.05). Second and similarly important were HbA1c reduction (14%), risk of hypoglycemia (13%), oral vs. injection treatment (13%), and risk of genital infection (12%). Next was risk of nausea (11%); weight reduction (8%) and risk of diarrhea (7%) were least important. The predicted therapy preference share was highest for low dose SGLTi, ranked first by 83% (z-test, p<0.05), compared with 8% for high dose SGLTi and 9% for pramlintide. In a separate question, respondents were asked to explicitly choose (masked to drug profile name and dose) among the clinical trial profiles of low dose SGLTi (chosen by 69%), high dose SGLTi (17%), pramlintide (6%), and ‘none of the above’ (9%).
In conclusion, the DCE and head-to-head explicit choice identified low dose SGLTi as the favored patient preference for adjunct therapy to insulin in T1D.</abstract><cop>New York</cop><pub>American Diabetes Association</pub><doi>10.2337/db19-1199-P</doi></addata></record> |
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| subjects | Diarrhea Drug dosages Hypoglycemia Insulin Nausea Patients Preferences |
| title | 1199-P: Analysis of Patient Preferences for Adjunct Therapy to Insulin in T1D |
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