Category: Federal Forum Posters
Purpose: Selection of specific adjuvant therapy for patients with type-2 diabetes unable to achieve glycemic control with metformin therapy remains controversial. Both glucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose cotransporter-2 inhibitors (SGLT-2) reduce glucose and weight effectively. Withdrawal of albiglutide from the market mandated review of all Veterans taking a GLP-1 RA for possible alternative therapy. Veterans previously prescribed GLP-1 RA were transitioned to empagliflozin due to added positive cardiorenal benefits, as clinically appropriate. The purpose of this quality improvement project is to assess change in hemoglobin A1c and body weight after Veterans were transitioned from GLP-1 RA to empagliflozin.
Methods: A retrospective chart review will be conducted from January 1, 2015 to February 28, 2019, which will include approximately 160 Veterans. For inclusion, Veterans must be treated initially with GLP-1 RA for a minimum of 90 days, then transitioned to empagliflozin for at least an additional 90 days. Veterans concurrently treated with both agents will be excluded. Veterans who do not have efficacy endpoints during the pre-specified timeframe will be excluded from efficacy analysis; however, will be included in safety analysis. Data collection will include race, age, sex, weight, hemoglobin A1c, estimated glomerular filtration rate, total insulin daily dose, and concurrent antidiabetic and weight loss medications. Data collected from each treatment arm during the prespecified time points will be compared using descriptive statistics. Additionally, safety endpoints will include gastrointestinal adverse drug reactions and genital infections.
Results: not applicable
Conclusion: not applicable
Bola Frances– PGY1 Pharmacy Resident, Orlando VA Medical Center, Oviedo, FL