Prioritizing Comparative Effectiveness Research Questions for Second-Line Treatment of Type 2 Diabetes: A Stakeholder Workshop
PCORI hosted a multi-stakeholder workshop to discuss whether comparative clinical effectiveness research (CER) can help to answer questions surrounding second-line treatment of type 2 diabetes. We asked representatives of a wide range of stakeholder groups, including patients, caregivers, clinicians, industry, payers, and researchers to participate in this discussion.
Given the burden that type 2 diabetes places upon patients and the health care system, effective treatment is a crucial area for patient-centered comparative clinical effectiveness research. There is consensus that metformin should be the first-line treatment after lifestyle modification, but second- and third-line approaches are less clear.
Ongoing comparative effectiveness research is looking at the glycaemia lowering effects of these medications (Nathan et al. Diabetes Care 36:2254–2261, 2013). Sulfonylureas, dipeptidyl peptidase 4 inhibitors (DPP-4), glucagon-like peptide 1 receptor agonists, and insulin are randomly assigned and added to metformin. In late 2015, researchers reported that empagliflozin, an inhibitor of sodium–glucose cotransporter 2 (SGLT2), is beneficial for patients with patients with type 2 diabetes at high risk for cardiovascular events (Zinman et al. N Engl J Med 2015;373:2117-28). In addition, there are ongoing trials of other SGLT2 inhibitors, including canagliflozin (NCT01032629) and dapagliflozin (NCT01730534).
This workshop engaged a broad spectrum of stakeholders to assess the value of undertaking other comparative effectiveness studies incorporating these newer agents, as well as discuss how best to address CER questions focused primarily around the use of SGLT-2, DPP-4 inhibitors, and potentially other classes of agents as appropriate.
In-person attendance was by invitation only, but the public was welcome to listen in via teleconference/webinar.
PCORI Workshops Introduction (9:00 am - 9:30 am ET)
Main Meeting Teleconference/Webinar (9:45 am - 5:00 pm ET)
- Topic Brief
- Presentation Slides
- Participants List
- Introduction Presentation Slides
- Workshops/Breakout Groups Chair Biographies
- Meeting Summary
Teleconference Audio Recordings
Workshop Part 1
Workshop Part 2