Does Race or Ethnicity Play a Factor in Type 2 Diabetes Treatment?

There are a substantial number of factors physicians must take into consideration before starting a patient with type 2 diabetes mellitus on a particular treatment path. According to results from a recent study, the effectiveness of one of the most popular diabetes medications may be dependent on a patient’s race or ethnicity.

Saxagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor used to lower glycated hemoglobin (HbA1c), was approved by the US Food and Drug Administration in 2009. With more data becoming available, researchers have been tracking the effects of the drug on various patient groups. This led Yu Chen Barrett of AstraZeneca and his colleagues to analyze potential differences in saxagliptin treatment outcomes based on race and ethnicity. The findings were presented at the American Diabetes Association 75^th Scientific Sessions in Boston, MA.

“The expectation was that we shouldn’t see a difference in efficiency between race or ethnicity,” one of the study’s authors Gianmaria Minervini, MD, told MD Magazine.

To determine if their suspicions were valid, the team gathered data from 9 phase 3 studies from which information was available on 2.5 mg/d and 5 mg/d doses of saxagliptin. The 4,648 patients in the studies with type 2 diabetes identified their race as either white, black, Asian, or other and their ethnicity as Hispanic or not Hispanic.

Participants within each group were assigned to 2.5 mg saxagliptin, 5 mg saxagliptin, or a placebo. Most of the trials lasted for a total of 24 weeks; however, for those that lasted longer only the data collected to that point were used in these results.

“If you look at the baseline, all of the groups look fairly similar with a few outstanding differences,” Minervini said.

Analysis of the data showed that each group had similar outcomes across the board. A significant percentage of patients reached a therapeutic response that was determined by an HbA1c of < 7%. However, one of those outstanding differences was that, on average, the Asian participants had a lower body weight index (BMI) when compared to the other groups.

The authors found that while each race had a clear distinction in achieved HbA1c levels between the medicated and placebo groups, Hispanics had a larger numerical drop. Even so, Minervini explained that this finding did not reach the level of statistical difference.

“The bottom line is, yes, saxagliptin at 2.5 mg or 5 mg dropped plasma glucose over 24 weeks regardless of race or ethnicity,” Minervini concluded.