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Prescribing of evidence-based diabetes pharmacotherapy in patients with metabolic dysfunction-associated steatohepatitis.

Publication ,  Journal Article
Alexopoulos, A-S; Parish, A; Olsen, M; Batch, BC; Moylan, C; Crowley, MJ
Published in: BMJ Open Diabetes Res Care
November 29, 2023

INTRODUCTION: Metabolic dysfunction-associated steatohepatitis (MASH) is highly prevalent in type 2 diabetes (T2D). Pioglitazone and glucagon-like peptide-1 receptor agonists (GLP-1RA) are medications used in T2D that can resolve MASH and should be considered in all patients with T2D and MASH. We assessed prescription rates of evidence-based T2D pharmacotherapy (EBP) in MASH, and ascertained racial/ethnic disparities in prescribing. RESEARCH DESIGN AND METHODS: We conducted a cross-sectional study on patients in Duke University Health System with diagnosis codes for T2D and MASH between January 2019 and January 2021. Only patients with ≥1 primary care or endocrinology encounter were included. The primary outcome was EBP, defined as ≥1 prescription for pioglitazone and/or a GLP-1RA during the study period. A multivariable logistic regression model was used to examine the primary outcome. RESULTS: A total of 847 patients with T2D and MASH were identified; mean age was 59.7 (SD 12) years, 61.9% (n=524) were female, and 11.9% (n=101) and 4.6% (n=39) were of Black race and Latino/a/x ethnicity, respectively. EBP was prescribed in 34.8% (n=295). No significant differences were noted in the rates of EBP use across racial/ethnic groups (Latino/a/x vs White patients: adjusted OR (aOR) 1.82, 95% CI 0.78 to 4.28; Black vs White patients: aOR 0.76, 95% CI 0.44 to 1.33, p=0.20). CONCLUSIONS: EBP prescriptions, especially pioglitazone, are low in patients with T2D and MASH, regardless of race/ethnicity. These data underscore the need for interventions to close the gap between current and evidence-based care.

Duke Scholars

Published In

BMJ Open Diabetes Res Care

DOI

EISSN

2052-4897

Publication Date

November 29, 2023

Volume

11

Issue

6

Location

England

Related Subject Headings

  • White
  • Pioglitazone
  • Middle Aged
  • Male
  • Humans
  • Hispanic or Latino
  • Glucagon-Like Peptide-1 Receptor
  • Female
  • Fatty Liver
  • Ethnicity
 

Citation

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Alexopoulos, A.-S., Parish, A., Olsen, M., Batch, B. C., Moylan, C., & Crowley, M. J. (2023). Prescribing of evidence-based diabetes pharmacotherapy in patients with metabolic dysfunction-associated steatohepatitis. BMJ Open Diabetes Res Care, 11(6). https://doi.org/10.1136/bmjdrc-2023-003763
Alexopoulos, Anastasia-Stefania, Alice Parish, Maren Olsen, Bryan C. Batch, Cynthia Moylan, and Matthew J. Crowley. “Prescribing of evidence-based diabetes pharmacotherapy in patients with metabolic dysfunction-associated steatohepatitis.BMJ Open Diabetes Res Care 11, no. 6 (November 29, 2023). https://doi.org/10.1136/bmjdrc-2023-003763.
Alexopoulos A-S, Parish A, Olsen M, Batch BC, Moylan C, Crowley MJ. Prescribing of evidence-based diabetes pharmacotherapy in patients with metabolic dysfunction-associated steatohepatitis. BMJ Open Diabetes Res Care. 2023 Nov 29;11(6).
Alexopoulos, Anastasia-Stefania, et al. “Prescribing of evidence-based diabetes pharmacotherapy in patients with metabolic dysfunction-associated steatohepatitis.BMJ Open Diabetes Res Care, vol. 11, no. 6, Nov. 2023. Pubmed, doi:10.1136/bmjdrc-2023-003763.
Alexopoulos A-S, Parish A, Olsen M, Batch BC, Moylan C, Crowley MJ. Prescribing of evidence-based diabetes pharmacotherapy in patients with metabolic dysfunction-associated steatohepatitis. BMJ Open Diabetes Res Care. 2023 Nov 29;11(6).

Published In

BMJ Open Diabetes Res Care

DOI

EISSN

2052-4897

Publication Date

November 29, 2023

Volume

11

Issue

6

Location

England

Related Subject Headings

  • White
  • Pioglitazone
  • Middle Aged
  • Male
  • Humans
  • Hispanic or Latino
  • Glucagon-Like Peptide-1 Receptor
  • Female
  • Fatty Liver
  • Ethnicity