(076) Treatment Modification Patterns of Glucose-Lowering Agents in Saudi Arabia: A Retrospective Real-world Data Analysis

Background: The growing number of newly approved antidiabetic medications has expanded therapeutic options worldwide, leading to varying prescribing patterns. Few studies identifying antidiabetic medications treatment modification patterns have been published; however, none was conducted in Saudi Arabia.

Objectives: To describe treatment modification patterns of antidiabetic medications in Saudi Arabia.

Methods: Patients aged 18 years or older who had at least one antidiabetic medication between 2016 and 2022 were included. The cohort follow-up started from the earliest dispensation of an antidiabetic medication until the last prescription, the date of inpatient admission, or the end of study. Treatment interruption was defined as a gap in treatment of more than 30 days since the last treatment episode. Two types of modification events were evaluated; the first was “add-on,” defined as any prescription of another antidiabetic class within a treatment episode, and the second was “switching,” defined as starting a new treatment episode with a new regimen after the end of the preceding one. Descriptive statistics were used to describe the study population and estimate proportions of treatment modification events.

Results: Of the 122,291 patients initially identified, 47.2% had treatment interruption or modification events, with a total of 303,781 events. Of these, 54% were treatment interruptions, 11% were add-on, and 35% were switching. The median time to the first interruption or modification event was 159 days. The most frequent add-on event included adding a DPP-4 inhibitor to biguanide and sulfonylurea dual therapy (8%), and sulfonylurea to biguanide monotherapy (8%). The most add-on events were single agents added to monotherapies (46%), followed by single agents added to dual therapies (28%). The patients had a total of 106,405 switching events, out of which 45% were de-escalation events. Of the switching events, 23% transitioned from dual to monotherapy, 17% moved from monotherapy to dual therapy, and 14% changed between various monotherapies.

Conclusions: In our study of antidiabetic medication modification patterns in Saudi Arabia, nearly half of the patients underwent treatment modifications or interruptions. There were significant shifts between monotherapies and dual therapies. These findings highlight the evolving landscape of antidiabetic treatment patterns in Saudi Arabia, underscoring the importance of understanding these trends for future research and clinical decision-making.