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Purpose The aim of this study was to evaluate the effectiveness and safety of combination therapy with a sodium-glucose cotransporter-2 (SGLT2) inhibitor and a glucagon-like peptide-1 receptor agonist (GLP1RA) in patients with inadequately controlled type 2 diabetes. Methods A retrospective search of electronic prescriptions of patients undergoing GLP1RA and SGLT2 inhibitor combination therapy was conducted. Once the patients had been identified, demographic data, blood and urine analyses (glycosylated hemoglobin [HbA1c], glucose, renal function, albuminuria, lipid profile, liver enzymes, and uric acid), physical examination (weight, body mass index, and blood pressure), and adverse effects were obtained from their electronic clinical records according to each of the following 3 periods: before the initiation of the combination, the first visit after initiation, and the last available visit. The influence of the duration of diabetes and the drug combination sequence on the effectiveness of the treatment was also analyzed. Statistical analysis was performed with SPSS version 21.0 (IBM SPSS Statistics, IBM Corporation, Armonk, New York). Quantitative variables are presented as mean and SD and were compared by using the Student t test, one-way ANOVA, or repeated measures ANOVA with Bonferroni correction. Categorical variables are expressed as percentages and were compared by using the χ2 test. Results A total of 212 patients were included, with women accounting for 52.4%. The mean age (SD) of the population was 61.5 (9.6) years. A significant reduction in HbA1c (−12 mmol/mol [–1.1%]) was observed with combined therapy (P Implications The findings of this study reveal the combined benefits of a GLP1RA and SGLT2 inhibitor in real-world clinical practice. In general, the combined treatment was well tolerated, and few adverse events were detected.

Purpose To evaluate the effectiveness, adverse reactions, and adherence to treatment of hypolipidemic inhibitors of proprotein convertase subtilisin/kexin type 9 (PCSK9is) in a context of real clinical practice. Methods We present an observational, retrospective, descriptive, multicenter study of patients with hypercholesterolemia who began treatment with PCSK9is between January 2017 and December 2019, with a minimum treatment period of 3 months. The main variable we recorded was the frequency of cardiovascular events (cardiovascular death, myocardial infarction, stroke, coronary revascularization, and hospitalization for unstable angina) in patients treated with PCSK9is. We recorded patient demographic characteristics and cardiovascular risk factors at onset of treatment as well as LDL-C levels and their reductions at 3, 6, 12, and 24 months. We calculated adherence to treatment and recorded the adverse reactions during treatment. Findings A total of 154 patients were studied, 64 (41.6%) of whom were treated with alirocumab and 90 (58.4%) with evolocumab. The initial dose of alirocumab was 75 mg every 14 days in 48 patients (75%) and 150 mg eery 14 days in 16 (25%). All patients who in the evolocumab group received a dose of 140 mg every 14 days. The mean (SD) basal LDL-C level was 159.6 (50.1) mg/dL, the level at 3 months was 87.9 (49.9) mg/dL (mean [SD] decrease, 44.5% [28.2%]), the level at 6 months was 86.7 (49.2) mg/dL (mean [SD] decrease, 46.3% [25.6%]), and the level at 12 months was 80.5 (41.4) (mean [SD] decrease, 48.9% [23.0%]). These values were maintained at 24 months (mean [SD], 80.3 [41.8] mg/dL; mean [SD] decrease, 47.9% [27.8%]). The percentage decrease of LDL-C for both drugs was approximately 50%, which was maintained until 24 months after treatment. Six patients (3.9%) presented with some cardiovascular event: acute myocardial infarction (2 [1.3%]), stroke (1 [0.65%]), coronary revascularization (1 [0.65%]), and hospitalization for unstable angina (2 [1.3%]). We did not see any adverse reactions related to PCSK9i treatment in 76.5% of patients. In the first 6 months, adherence to treatment with PCSK9is, measured as the possession ratio, was a mean (SD) of 99.4% (3.9%). In the rest of the study period (6–24 months), the mean (SD) adherence to treatment was 99.2% (4.7%). Implications The frequency of cardiovascular events in patients treated with PCSK9is was low and occurred despite adequate adherence to treatment (100% possession ratio) with PCSK9is and concomitant treatment with other hypolipidemics. The effectiveness of PCSK9is is similar to that referred to in other published studies with PCSK9is, and this was maintained in the long term (24 months) with few adverse events, all of which were mild.

Dyslipidemia is commonly found in T1D adults and increases the risk of CVD. There is no research on dyslipidemia in T1D adults in Spain so far. The aim of the study was to evaluate the prevalence and the pattern of dyslipidemia and its relationship with other risk factors or comorbidities. Methods: A multicentric, cross-sectional study in Spain included 1252 adults with T1D who visited Diabetes Clinic from December 2017 to December 2018. Cut-off points for abnormal lipid levels (total cholesterol (TC) ≥200 mg/dL, LDL ≥130 mg/dL, HDL ≤35 mg/dL, and triglycerides (TG) ≥150 mg/dL) were taken from the Third Report of the National Cholesterol Education Program and the ADA. Dyslipidemia was defined by the presence of one or more abnormal serum lipid concentrations. Results: Among 1252 patients 50,3% were male. Median age 40,5+/-13 years old and the median duration of diabetes was 20+/-13 years. Median A1c 7,96+/-2,49% and BMI 25,7+/-4,6kg/m2 The overall lipid profile was TC 188+/-42 mg/dL, LDL 109+/-36 mg/dL, HDL 59+/-17 mg/dL and TG 96+/-96 mg/dL. The prevalence of dyslipidemia was 43,5%. The most frequent dyslipidemia found wash high TC (34,6%), followed by high LDL (26,6%), high TG (11,3%) and low HDL (1,8%). Comparison between the dyslipidemic (D) group and normolipidemic (No D) group age was significantly higher in the D group P< 0,001). The frequency of dyslipidemia was higher in male, current smokers and hypertension. There were no differences between the D and No D groups in terms of A1c, BMI, family background, hypoglycemic treatment or duration of diabetes. The prevalence of microvascular complications was higher in the D group (p< 0,0001), there were no differences in macrovascular complications. Conclusions: Our study was the first report of lipid data in Spanish T1D adults. We have shown that the overall lipid pattern was comparable to that in nondiabetic individuals. There is high prevalence of dyslipidemia which was associated with age, sex (male), smoking and comorbidities but not with glycemic control. Disclosure M. Rodriguez Carnero: None. D. Bellido Guerrero: None. C. Tejera: None. M. López de la Torre: None. A. Soto González: None. F.J. Escalada: Advisory Panel; Self; Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. Consultant; Self; Esteve, Lilly Diabetes. Speaker's Bureau; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. A. Hernandez-Mijares: None. L. Suarez Gutierrez: None. C. Morales: Other Relationship; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. L. Gutiérrez Carrasqu: None. A. Cadenas: Advisory Panel; Self; Janssen Pharmaceuticals, Inc. O. Díaz Trastoy: None. J. Amigó-Farran: None. I. Gonzalez molero: None. V. Bellido: None. F. Arrieta: None. F. Tinahones: Advisory Panel; Self; Lilly Diabetes, Novo Nordisk A/S, Regeneron Pharmaceuticals, Sanofi-Aventis. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; Danone Nutricia Research, Lilly Diabetes, Novo Nordisk A/S, Regenerative Medical Solutions, Sanofi-Aventis.

Introduction: Cardiovascular disease (CVD) is the major cause of mortality in T1D. Lipid-lowering treatment (LLT) with statins prevent major cardiovascular events and dead in a broad spectrum of patients. However, evidence of CVD risks factors and its management are based on subgroup analyses and extrapolations of effects demonstrates in other populations. Objectives: The aim of the study was to analyze the differences between T1D adults on lipid-lowering treatment (T group) and without treatment (No T group). We pay special attention to CVD risk factors, comorbidities and which factors are associated with receiving lipid-lowering treatment. Research design and Methods: A multicentric, cross-sectional study in Spain included 1252 T1D adults who visited Diabetes Clinic from December 2017 to December 2018. Results: Among 1252 patients 344 were on LLT. In terms of lipid profile LDL (131 vs. 100 mg/dL), HDL (57 vs. 60 mg/dL), total cholesterol (213 vs. 178 mg/dL) and triglycerides (125 vs. 85 mg/dL) levels were statistically significant while compared between T and No T groups. T group was older (48 vs. 37 years old) and the median duration of diabetes was higher (25 vs. 18 years)than No T group (p< 0.000). BMI in T group was 27 kg/m2 higher than no T group (25 kg/m2) (p < 0,0001). There was a trend toward higher prevalence of microvascular (57% vs. 23,8%) and macrovascular complications (13,7% vs. 3,6%) in T group than in No T (p < 0,000). A positive association was found between sex (male), smoking, high blood pressure and to be on treatment. There were no differences between the T group and No T group in terms of A1c (A1c 7,90% vs. 7,99%) or fasting glucose (157 vs.161 mg/dl). Conclusions: This multicentric study shows that starting LLT is associated with LDL > 100 mg/dL, aged, sex (male), duration of diabetes, high BMI, comorbidities, smoking and a high blood pressure. Our results show compliance with the recommendations of 2014 AHA/ADA scientific statement type 1 diabetes mellitus and Cardiovascular Disease. Disclosure M. Rodriguez Carnero: None. D. Bellido Guerrero: None. C. Tejera: None. M. López de la Torre: None. A. Soto González: None. F.J. Escalada: Advisory Panel; Self; Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. Consultant; Self; Esteve, Lilly Diabetes. Speaker's Bureau; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. A. Hernandez-Mijares: None. L. Suarez Gutierrez: None. C. Morales: Other Relationship; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. L. Gutiérrez Carrasqu: None. A. Cadenas: Advisory Panel; Self; Janssen Pharmaceuticals, Inc. O. Díaz Trastoy: None. J. Amigó-Farran: None. I. Gonzalez molero: None. V. Bellido: None. F. Arrieta: None. F. Tinahones: Advisory Panel; Self; Lilly Diabetes, Novo Nordisk A/S, Regeneron Pharmaceuticals, Sanofi-Aventis. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; Danone Nutricia Research, Lilly Diabetes, Novo Nordisk A/S, Regenerative Medical Solutions, Sanofi-Aventis.