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Use of diabetes medications in adults with T2D and CVD in Japan: secondary analysis of the CAPTURE study

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Abstract

Introduction

The CAPTURE study estimated the global prevalence of established cardiovascular disease (CVD) and characterized the usage of glucose-lowering agents (GLAs) in adults with type 2 diabetes (T2D) across 13 countries. The purpose of this secondary analysis of data from the Japanese sites within CAPTURE (NCT03786406, NCT03811288) was to provide data about medication usage stratified by CVD status among Japanese participants with T2D.

Materials and methods

Data on GLA usage (including those with proven cardiovascular [CV] benefits) in Japanese participants with T2D managed in clinics or hospitals were collected and stratified by CVD subgroups.

Results

There were 800 Japanese participants in the CAPTURE study (n = 502 [no CVD group], n = 298 [CVD group], n = 268 [atherosclerotic CVD subgroup]). Oral antidiabetic agents and insulin were used by 88.5% and 23.4%, respectively, of participants overall. Among participants with established CVD, dipeptidyl peptidase-4 inhibitors (65.1%) were most frequently used, followed by biguanides (50.7%) and insulins (26.2%). The pattern was similar among participants with atherosclerotic CVD. A lower proportion of participants in the CVD group used glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is) with proven CV benefits versus the no CVD group (GLP-1 RAs: 7.0% vs. 8.6%; SGLT-2is: 13.4% vs. 19.1%).

Conclusion

This analysis of the CAPTURE study provided a comprehensive overview of prescription patterns for the treatment of T2D in Japan. Use of GLAs with proven CV benefit was low, even in participants with established CVD, which was comparable to the findings from the global cohort.

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Data availability

Upon reasonable request, the datasets used and/or analyzed during the current study are available from the lead author.

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Acknowledgements

This study was funded by Novo Nordisk A/S. The authors would like to thank the study participants, investigators, and coordinators. Medical writing support was provided by Dhara P. Patel and Beth Campbell, on behalf of Ashfield MedComms, and editorial assistance provided by Helen Marshall of Ashfield MedComms, an Inizio company, and funded by Novo Nordisk A/S.

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Authors and Affiliations

  1. The Institute of Medical Science, Asahi Life Foundation, 2-2-6 Nihonbashibakurocho, Chuo-ku, Tokyo, 103-0002, Japan

    Yukiko Onishi

  2. HEC Science Clinic, Yokohama, Japan

    Shinichiro Shirabe

  3. Novo Nordisk Pharma Ltd., Tokyo, Japan

    Kosei Eguchi, Keiji Nishijima & Toshihiro Sato

  4. Seino Internal Medicine Clinic, Fukushima, Japan

    Hiroaki Seino

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  1. Yukiko Onishi
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Contributions

YO, SS, and HS were investigators in the study and collected data. TS and KN contributed to statistical analyses required for the Japan data. All authors reviewed and edited drafts of the manuscript prior to submission. The authors confirm that they meet the International Committee of Medical Journal Editors uniform authorship requirements and that they have contributed to critical analysis and interpretation of the data, critically revised the article, and share in the final responsibility for manuscript content, as well as the decision to submit it for publication.

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Correspondence to Yukiko Onishi.

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Conflict of interest

YO has received honoraria/lecture fees from Novo Nordisk Pharma Ltd. and Sumitomo Pharma. SS has received honoraria/lecture fees from Eli Lilly Japan K.K., Novo Nordisk Pharma Ltd. and Sumitomo Pharma. KE and TS are employees of Novo Nordisk. KN holds shares in and is an employee of Novo Nordisk. HS has received research funding from Astellas Pharma Inc., Taisho Toyama Pharmaceutical, Takeda Pharmaceutical, Novo Nordisk Pharma, Sanofi, Mitsubishi Tanabe Pharma Co., Novartis Pharma K.K., Shionogi Pharma Co. Ltd., Boehringer Ingelheim, AstraZeneca K.K., and MSD; and honoraria from Shionogi Pharma Co., Mitsubishi Tanabe Pharma Co., Astellas Pharma Inc., Novartis Pharma K.K., Eli Lilly, Ono Pharmaceutical Co., MSD, and Sanofi.

Ethical approval

The protocol was approved by the IEC or other appropriate body and was provided by each investigator prior to undertaking any study-related activities. Specifically, the protocol was approved by: Institute for Adult Diseases, Asahi Life Foundation Institutional Review Board (approval date: 03 Dec 2018; approval number: 11000766); Medical Corporation Ichi YouKai Institutional Review Board Makato Honda Board (approval date: 13 Feb 2019; approval number: 14000077); Seino Naika Clinic Chairman, Ethical Review Board (approval date: 15 Dec 2018; approval number: 18000150); Shinagawa East One Medical Clinic Ethical Review Board Shinagawa East One Medical Clinic (approval date: 26 Nov 2018; approval number: 11000993); Nihonbashi Sakura Clinic Institutional Review Board (approval date: 05 Dec 2018; approval number: 11001007); Heiwadai Hospital Institutional Review Board (approval date: 21 Nov 2018; approval number: 11000861); Jinnouchi Hospital Ethical Review Board (approval date: 10 Dec 2018; approval number: 16000034); Kouhoukai Ethical Committee (approval date: 03 Dec 2018; approval number: 18000145); Hospital Joint Institutional Review Board (approval date: 21 Dec 2018; approval number: 14000050); and Institutional Review Board for Considering the Ethics of Special Non-Profit Entity Clinical Trials (approval date: 28 Jan 2019; approval number: 12000065).

Human research

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and/or with the Helsinki Declaration of 1964 and later versions. Informed consent was provided by each participant prior to undertaking any study-related activities (during the first and only study visit).

Informed consent

Informed consent was provided by each participant prior to undertaking any study-related activities (during the first and only study visit).

Approval date of registry and registration no. of the study/trial

NCT03786406, 26 December 2018 and NCT03811288, 22 January 2019.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be submitted.

Prior presentation

Some of the results from this study were previously presented at the 64th Annual Meeting of the Japanese Diabetes Society, virtual meeting, 2021.

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Onishi, Y., Shirabe, S., Eguchi, K. et al. Use of diabetes medications in adults with T2D and CVD in Japan: secondary analysis of the CAPTURE study. Diabetol Int 14, 363–371 (2023). https://doi.org/10.1007/s13340-023-00638-w

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