Safety and Effectiveness of Ipragliflozin in Elderly Versus Non-elderly Japanese Patients with Type 2 Diabetes: Subgroup Analysis of STELLA-LONG TERM

Ichiro Nakamura, Hiroshi Maegawa, Kazuyuki Tobe, Satoshi Uno, Ichiro Nakamura, Hiroshi Maegawa, Kazuyuki Tobe, Satoshi Uno

Abstract

Introduction: STELLA-LONG TERM is a post-marketing surveillance study evaluating the safety and effectiveness of ipragliflozin in Japanese patients with type 2 diabetes mellitus.

Methods: Patients were classified by age at ipragliflozin initiation (< 65 and ≥ 65 years), and elderly patients were subclassified by baseline body mass index (BMI) < 25.0 or ≥ 25.0 kg/m2. Incidence of adverse drug reactions (ADRs) and effectiveness were evaluated over 3 years.

Results: Among 11,051 patients, 7894 (71.4%) were aged < 65 years and 3157 (28.6%) ≥ 65 years. The 3-year ADR incidence was similar in patients aged ≥ 65 (19.04%) and < 65 years (19.36%; P = 0.701). Serious ADRs were more frequent in the subgroup ≥ 65 years (2.79% vs 1.55%; P < 0.001). In terms of ADRs of special interest, a significantly greater proportion of elderly patients had skin complications (2.22% vs 1.62%, P = 0.033), renal disorders (2.28% vs 1.51%, P = 0.005), hypoglycemia (0.73% vs 0.43%, P = 0.048), or malignant tumors (1.01% vs 0.24%, P < 0.001), while the incidence of polyuria/pollakiuria (5.97% vs 4.47%, P = 0.002) and hepatic disorders (1.39% vs 0.73%, P = 0.004) was significantly higher in non-elderly than elderly patients. In patients aged ≥ 65 years, the incidence of ADRs was higher when baseline BMI was ≥ 25 kg/m2 versus < 25 kg/m2 (24.40% vs 17.68%; P < 0.001). Glycosylated hemoglobin, fasting blood glucose, and body weight significantly decreased from baseline in both age groups at each evaluation up to 3 years (all P < 0.001).

Conclusions: Ipragliflozin was well tolerated and effective for 3 years in routine clinical use in elderly and non-elderly patients, although elderly patients had a higher rate of serious ADRs. No new safety concerns were identified.

Clinical trial registration: ClinicalTrials.gov identifier NCT02479399.

Keywords: Elderly; Ipragliflozin; Japan; Post-marketing surveillance; Sodium-glucose cotransporter 2 inhibitor; Type 2 diabetes mellitus.

Figures

Fig. 1
Fig. 1
Mean ± standard deviation (SD) changes in glycated hemoglobin (HbA1c) by age in a the effectiveness analysis population, b patients with baseline HbA1c < 8%, and c patients with baseline HbA1c ≥ 8%. Tables show the absolute mean ± SD values at baseline and 3 years. *P < 0.001 vs baseline (one-sample t test)
Fig. 2
Fig. 2
Mean ± standard deviation (SD) changes in glycated hemoglobin (HbA1c) by BMI (2) in elderly patients: a patients aged ≥ 65 years, b patients aged 65 to < 75 years, and c patients aged ≥ 75 years. Tables show the absolute mean ± SD values at baseline and 3 years. *P < 0.001 vs baseline (one-sample t test)
Fig. 3
Fig. 3
Mean ± standard deviation (SD) changes in body weight by age in a the effectiveness analysis population, b patients with a baseline BMI < 25 kg/m2, and c patients with a baseline BMI ≥ 25 kg/m2. Tables show the absolute mean ± SD values at baseline and 3 years. *P < 0.001 vs baseline (one-sample t test)

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Source: PubMed

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