2024
Kidney Outcomes with GLP-1RAs, SGLT2 Inhibitors, DPP-4 Inhibitors, and Sulfonylureas in Type 2 Diabetes and Moderate Cardiovascular Risk
Neumiller J, Herrin J, Swarna K, Polley E, Galindo R, Umpierrez G, Deng Y, Ross J, Mickelson M, McCoy R. Kidney Outcomes with GLP-1RAs, SGLT2 Inhibitors, DPP-4 Inhibitors, and Sulfonylureas in Type 2 Diabetes and Moderate Cardiovascular Risk. Clinical Journal Of The American Society Of Nephrology 2024 DOI: 10.2215/cjn.0000000587.Peer-Reviewed Original ResearchSodium-glucose co-transporter 2 inhibitorsGlucagon-like peptide-1 receptor agonistsSodium-glucose co-transporter 2Dipeptidyl peptidase-4 inhibitorsGlucagon-like peptide-1Dipeptidyl peptidase-4Receptor agonistsPrimary composite outcomeKidney replacement therapyChronic kidney diseaseComposite outcomeSecondary composite outcomeType 2 diabetesGLP-1 receptor agonist therapyCVD riskCardiovascular diseaseModerate CVD riskPrescribed glucose-lowering agentsBaseline CVD riskHigh-risk patientsAssociated with risk reductionCKD stage 3Retrospective observational studyGlucose-lowering agentsModerate cardiovascular riskEffectiveness of glucose-lowering medications on cardiovascular outcomes in patients with type 2 diabetes at moderate cardiovascular risk
McCoy R, Herrin J, Swarna K, Deng Y, Kent D, Ross J, Umpierrez G, Galindo R, Crown W, Borah B, Montori V, Brito J, Neumiller J, Mickelson M, Polley E. Effectiveness of glucose-lowering medications on cardiovascular outcomes in patients with type 2 diabetes at moderate cardiovascular risk. Nature Cardiovascular Research 2024, 3: 431-440. PMID: 38846711, PMCID: PMC11156225, DOI: 10.1038/s44161-024-00453-9.Peer-Reviewed Original ResearchAdverse cardiovascular eventsGlucose-lowering medicationsType 2 diabetesCardiovascular diseaseGLP-1RACardiovascular eventsGlucagon-like peptide-1 receptor agonistsSodium-glucose cotransporter 2 inhibitorsPeptide-1 receptor agonistsDipeptidyl peptidase-4 inhibitorsPeptidase-4 inhibitorsRetrospective cohort studyCardiovascular disease risk reductionGlucose-lowering agentsModerate cardiovascular riskCardiovascular risk reductionReceptor agonistsEffects of glucose-lowering medicationsRisk reductionCardiovascular riskCohort studyCardiovascular outcomesHigh riskBaseline riskModerate riskDerivation of an Annualized Claims-Based Major Adverse Cardiovascular Event Estimator in Type 2 Diabetes
McCoy R, Swarna K, Deng Y, Herrin J, Ross J, Kent D, Borah B, Crown W, Montori V, Umpierrez G, Galindo R, Brito J, Mickelson M, Polley E. Derivation of an Annualized Claims-Based Major Adverse Cardiovascular Event Estimator in Type 2 Diabetes. JACC Advances 2024, 3: 100852. PMID: 38939660, PMCID: PMC11198625, DOI: 10.1016/j.jacadv.2024.100852.Peer-Reviewed Original ResearchType 2 diabetesMedicare fee-for-service planClaims-based prediction modelPopulation risk stratificationRisk of Major Adverse Cardiovascular EventsMajor adverse cardiovascular eventsNon-Hispanic whitesFee-for-service plansStudy cohortClinical trials of cardiovascular diseaseCox proportional hazards modelsProportional hazards modelCare populationHealth systemPrimary preventionMedicare AdvantageParticipant identificationPayer levelPharmacy claimsDecentralized clinical trialsHazards modelCardiovascular diseaseRisk predictionMedicarePatient population
2023
Comparative effectiveness of second line glucose lowering drug treatments using real world data: emulation of a target trial
Deng Y, Polley E, Wallach J, Herrin J, Ross J, McCoy R. Comparative effectiveness of second line glucose lowering drug treatments using real world data: emulation of a target trial. BMJ Medicine 2023, 2: e000419. PMID: 37577025, PMCID: PMC10414064, DOI: 10.1136/bmjmed-2022-000419.Peer-Reviewed Original ResearchYear cumulative incidence rateCumulative incidence rateType 2 diabetesLiraglutide armMetabolic failureSitagliptin armGlycaemic controlInsulin glargineMedian timeIncidence rateComparative effectivenessCox proportional hazards regressionPropensity scoreTarget trialsInsulin glargine armProportional hazards regressionOptumLabs Data WarehouseTarget trial emulationStatistical analysis planMetformin monotherapyMacrovascular complicationsMicrovascular outcomesStudy drugStudy armsTrial emulation
2022
Emulating the GRADE trial using real world data: retrospective comparative effectiveness study
Deng Y, Polley EC, Wallach JD, Dhruva SS, Herrin J, Quinto K, Gandotra C, Crown W, Noseworthy P, Yao X, Lyon TD, Shah ND, Ross JS, McCoy RG. Emulating the GRADE trial using real world data: retrospective comparative effectiveness study. The BMJ 2022, 379: e070717. PMID: 36191949, PMCID: PMC9527635, DOI: 10.1136/bmj-2022-070717.Peer-Reviewed Original ResearchConceptsSecondary outcomesMetformin monotherapyTreatment groupsRetrospective comparative effectiveness studyCox proportional hazards regressionPropensity scoreIncident microvascular complicationsNationwide claims databaseProportional hazards regressionType 2 diabetesComparative effectiveness studiesMacrovascular complicationsMicrovascular complicationsProspective trialAdverse eventsGlycemic controlHospital admissionInsulin glarginePrimary outcomeMedian timeHazards regressionClaims databaseObservational studyInverse propensity scoreEligibility criteria
2021
Second-Line Therapy for Type 2 Diabetes Management: The Treatment/Benefit Paradox of Cardiovascular and Kidney Comorbidities.
McCoy RG, Van Houten HK, Karaca-Mandic P, Ross JS, Montori VM, Shah ND. Second-Line Therapy for Type 2 Diabetes Management: The Treatment/Benefit Paradox of Cardiovascular and Kidney Comorbidities. Diabetes Care 2021, 44: 2302-2311. PMID: 34348996, PMCID: PMC8929191, DOI: 10.2337/dc20-2977.Peer-Reviewed Original ResearchSodium-glucose cotransporter 2 inhibitorsGLP-1RAsHeart failureRelative risk ratiosDPP-4iMyocardial infarctionOlder patientsCerebrovascular diseaseCardiovascular diseaseGlucagon-like peptide-1 receptor agonistsPeptide-1 receptor agonistsDipeptidyl peptidase-4 inhibitorsType 2 diabetes managementDPP-4i therapySecond-line therapyCotransporter 2 inhibitorsPrior myocardial infarctionPeptidase-4 inhibitorsOptumLabs Data WarehouseType 2 diabetesMedicare Advantage beneficiariesMedication classesSGLT2i therapyClinical factorsRisk ratioComparison of Diabetes Medications Used by Adults With Commercial Insurance vs Medicare Advantage, 2016 to 2019
McCoy RG, Van Houten HK, Deng Y, Mandic PK, Ross JS, Montori VM, Shah ND. Comparison of Diabetes Medications Used by Adults With Commercial Insurance vs Medicare Advantage, 2016 to 2019. JAMA Network Open 2021, 4: e2035792. PMID: 33523188, PMCID: PMC7851726, DOI: 10.1001/jamanetworkopen.2020.35792.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsDipeptidyl peptidase-4 inhibitorsCommercial insurance beneficiariesMedicare Advantage beneficiariesDPP-4i treatmentGLP-1RAsType 2 diabetesInsurance beneficiariesMedicare AdvantageGlucose levelsGlucagonlike Peptide-1 Receptor AgonistsPeptide-1 receptor agonistsHealth plansCommercial health insurance plansGLP-1RA treatmentRetrospective cohort studyCotransporter 2 inhibitorsInitiation of treatmentPeptidase-4 inhibitorsLow-income patientsSeparate logistic regression modelsAdministrative claims dataCommercial health plansAdjusted annual rateLogistic regression models
2020
Patient and provider-level factors associated with changes in utilization of treatments in response to evidence on ineffectiveness or harm
Smith LB, Desai NR, Dowd B, Everhart A, Herrin J, Higuera L, Jeffery MM, Jena AB, Ross JS, Shah ND, Karaca-Mandic P. Patient and provider-level factors associated with changes in utilization of treatments in response to evidence on ineffectiveness or harm. International Journal Of Health Economics And Management 2020, 20: 299-317. PMID: 32350680, PMCID: PMC7725279, DOI: 10.1007/s10754-020-09282-2.Peer-Reviewed Original ResearchConceptsPermanent atrial fibrillationType 2 diabetesAtrial fibrillationPermanent atrial fibrillation patientsProvider-level factorsAtrial fibrillation patientsEffective new therapiesPrimary care providersUse of medicationsProvider-level characteristicsUtilization of treatmentHigh-quality health careDronedarone useInterrupted time-series regression modelsFibrillation patientsMedication useDiabetes patientsProvider characteristicsCare providersMedicare feeNew therapiesService claimsFemale providersPatientsMedications
2019
Adoption of New Glucose-Lowering Medications in the U.S.—The Case of SGLT2 Inhibitors: Nationwide Cohort Study
McCoy R, Dykhoff HJ, Sangaralingham L, Ross JS, Karaca-Mandic P, Montori VM, Shah N. Adoption of New Glucose-Lowering Medications in the U.S.—The Case of SGLT2 Inhibitors: Nationwide Cohort Study. Diabetes Technology & Therapeutics 2019, 21: 702-712. PMID: 31418588, PMCID: PMC7207017, DOI: 10.1089/dia.2019.0213.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsGlucose-lowering medicationsHeart failureKidney diseaseMyocardial infarctionHigh-quality diabetes careMedicare Advantage insurancePrevalent adverse effectsRenal protective benefitsTreatment-risk paradoxNationwide cohort studyCotransporter 2 inhibitorsGlucose-lowering therapyPrior myocardial infarctionGlucose lowering medicationsChronic diabetes complicationsMultivariable logistic regressionNon-black patientsType 2 diabetesDiabetes type 1Insurance-related factorsCommercial health insuranceAppropriateness of usePrior hypoglycemiaSGLT2i initiation
2016
Trends in Drug Utilization, Glycemic Control, and Rates of Severe Hypoglycemia, 2006–2013
Lipska KJ, Yao X, Herrin J, McCoy RG, Ross JS, Steinman MA, Inzucchi SE, Gill TM, Krumholz HM, Shah ND. Trends in Drug Utilization, Glycemic Control, and Rates of Severe Hypoglycemia, 2006–2013. Diabetes Care 2016, 40: 468-475. PMID: 27659408, PMCID: PMC5360291, DOI: 10.2337/dc16-0985.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedBlood GlucoseComorbidityDiabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsDrug UtilizationFemaleGlycated HemoglobinHumansHypoglycemiaHypoglycemic AgentsInsulinLogistic ModelsMaleMetforminMiddle AgedRetrospective StudiesSulfonylurea CompoundsThiazolidinedionesYoung AdultConceptsGlycemic controlSevere hypoglycemiaOlder patientsDipeptidyl peptidase-4 inhibitorsGlucose-lowering drugsGlucose-lowering medicationsProportion of patientsOverall glycemic controlPeptidase-4 inhibitorsMedicare Advantage patientsSex-standardized ratesType 2 diabetesOverall rateClass of agentsMore comorbiditiesChronic comorbiditiesYounger patientsAdvantage patientsDrug utilizationClaims dataPatientsHypoglycemiaHemoglobin AT2DMComorbiditiesIntensive Treatment and Severe Hypoglycemia Among Adults With Type 2 Diabetes
McCoy RG, Lipska KJ, Yao X, Ross JS, Montori VM, Shah ND. Intensive Treatment and Severe Hypoglycemia Among Adults With Type 2 Diabetes. JAMA Internal Medicine 2016, 176: 969-78. PMID: 27273792, PMCID: PMC5380118, DOI: 10.1001/jamainternmed.2016.2275.Peer-Reviewed Original ResearchConceptsType 2 diabetesHigh clinical complexityRisk-adjusted probabilitySevere hypoglycemiaIntensive treatmentClinical complexityStandard treatmentIntensive glucose-lowering treatmentEnd-stage renal diseasePatient clinical complexityGlucose-lowering medicationsGlucose-lowering treatmentUse of insulinRisk of hypoglycemiaOptumLabs Data WarehouseAdults 18 yearsSerious chronic conditionsEligible patientsHbA1c levelsRenal diseaseHbA1c testEmergency departmentChronic conditionsPractice guidelinesRetrospective analysis
2015
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study
McCoy RG, Van Houten HK, Ross JS, Montori VM, Shah ND. HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study. The BMJ 2015, 351: h6138. PMID: 26646052, PMCID: PMC4673101, DOI: 10.1136/bmj.h6138.Peer-Reviewed Original ResearchConceptsType 2 diabetesGlycemic controlControlled type 2 diabetesNational administrative claims databaseExcessive testingAdministrative claims databaseGood glycemic controlStable glycemic controlStudy patientsTreatment intensificationSevere hypoglycemiaTreatment regimenStudy cohortUS patientsClaims databasePotential overtreatmentUS cohortHypoglycemic drugsInsulin treatmentPatient burdenRetrospective analysisStudy populationUS adultsDiabetes managementObservational population