Persistence and adherence to sodium-glucose co-transporter 2 inhibitor monotherapy among patients with type 2 diabetes mellitus: a retrospective study based on a Japanese claims database

The aims of this retrospective study were to examine persistence/adherence rates to sodium-glucose co-transporter 2 inhibitors (SGLT2i) monotherapy in patients with type 2 diabetes (T2DM) and identify factor(s) affecting persistence/adherence. Claims data on patients with T2DM newly using SGLT2i monotherapy from the JMDC database between October 2017 and September 2020 were analyzed. Persistence without a 90-day gap was calculated from the index date until the time of discontinuation of SGLT2i in a 1-year follow-up. Adherence was calculated using the proportion of days covered (PDC). Baseline characteristics were examined as potential factors affecting persistence/adherence using a multivariate logistic method. The present study identified 2172 new users of SGLT2i monotherapy. The persistence rate to SGLT2i after 365 days was 61.0%. Mean PDC was 71.2%, and 58.3% of patients adhered to treatment. A multivariate logistic regression analysis showed that an older age, hypertension, dyslipidemia, and hyperuricemia were associated with a lower risk of the discontinuation of SGLT2i monotherapy, while an older age, hypertension, dyslipidemia, and hyperuricemia were associated with a lower risk of poor adherence. The present study identified several factors that reduced the risk of discontinuation/poor adherence to SGLT2i monotherapy in patients with T2DM. An older age, hypertension, dyslipidemia, and hyperuricemia were common factors for a lower risk of discontinuation/poor adherence.