A study reveals that treatment with sotagliflozin in hospitalized patients with type 2 diabetes or T2D leads to an increase in the number of days alive and out of the hospital or DAOH, a metric that may provide an additional patient-centered outcome to capture the totality of disease burden.
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There was a total of 1,222 patients with T2D and
reduced or preserved ejection fraction who were recently hospitalized for
worsening heart failure at 306 sites in 32 countries were randomized to receive
200mg of sotagliflozin once a day, with a possible dose increase to 400mg or
matching placebo. DAOH and its converse (days dead and in the hospital) were analyzed
using pre-specified Poisson regression models.
Proportion of patients hospitalized at least once was comparable
between sotagliflozin and placebo groups, 38.5% vs 41.4%, however, fewer
patients on sotagliflozin were hospitalized more than once, 16.3% vs 22.1% or
had died, 64 vs 76.
Specifically, the rate of DAOH was 3% higher in the sotagliflozin
than in the placebo group. Difference was driven by a reduction in the rate of
days dead rather than by the reduction in the rate of days hospitalized for any
causes.
Moreover, patients on sotagliflozin medication were
alive and out of the hospital for 2.9 more days than those on placebo, 91.8 vs
88.9 days, for every 100 days of follow-up. With the difference showed a
2.6-day difference in days dead, 6.3 vs 8.9 days, and a 0.3-day difference in
days hospitalized.
Researchers said that further studies are needed to
quantify the consequences of increasing DAOH (days alive and out of hospital)
in terms of health economics and patient quality of life.
Source: Ann Intern Med 2021;doi:10.7326/M21-0651