Publications by year
In Press
Dennis J, Henley W, Weedon M, Lonergan M, Rodgers L, Jones A, Hamilton W, Sattar N, Janmohamed S, Holman R, et al (In Press). Sex and BMI alter the benefits and risks of sulfonylureas and thiazolidinediones in type 2 diabetes: a framework for evaluating stratification using routine clinical and individual trial data.
Diabetes Care Full text.
McGovern A, Shields B, Hattersley A, Pearson E, Jones AG (In Press). What to do with diabetes therapies when HbA1c lowering is inadequate: add, switch, or continue? a MASTERMIND study.
BMC Medicine Full text.
2020
McGovern AP, Hogg M, Shields BM, Sattar NA, Holman RR, Pearson ER, Hattersley AT, Jones AG, Dennis JM (2020). Risk factors for genital infections in people initiating SGLT2 inhibitors and their impact on discontinuation.
BMJ Open Diabetes Research & Care,
8(1), e001238-e001238.
Abstract:
Risk factors for genital infections in people initiating SGLT2 inhibitors and their impact on discontinuation
IntroductionTo identify risk factors, absolute risk, and impact on treatment discontinuation of genital infections with sodium-glucose co-transporter-2 inhibitors (SGLT2i).Research design and methodsWe assessed the relationship between baseline characteristics and genital infection in 21 004 people with type 2 diabetes initiating SGLT2i and 55 471 controls initiating dipeptidyl peptidase-4 inhibitors (DPP4i) in a UK primary care database. We assessed absolute risk of infection in those with key risk factors and the association between early genital infection and treatment discontinuation.ResultsGenital infection was substantially more common in those treated with SGLT2i (8.1% within 1 year) than DPP4i (1.8%). Key predictors of infection with SGLT2i were female sex (HR 3.64; 95% CI 3.23 to 4.11) and history of genital infection; <1 year before initiation (HR 4.38; 3.73 to 5.13), 1–5 years (HR 3.04; 2.64 to 3.51), and >5 years (HR 1.79; 1.55 to 2.07). Baseline HbA1c was not associated with infection risk for SGLT2i, in contrast to DPP4i where risk increased with higher HbA1c. One-year absolute risk of genital infection with SGLT2i was highest for those with a history of prior infection (females 23.7%, males 12.1%), compared with those without (females 10.8%, males 2.7%). Early genital infection was associated with a similar discontinuation risk for SGLT2i (HR 1.48; 1.21–1.80) and DPP4i (HR 1.58; 1.21–2.07).ConclusionsFemale sex and history of prior infection are simple features that can identify subgroups at greatly increased risk of genital infections with SGLT2i therapy. These data can be used to risk-stratify patients. High HbA1c is not a risk factor for genital infections with SGLT2i.
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Angwin C, Jenkinson C, Jones A, Jennison C, Henley W, Farmer A, Sattar N, Holman RR, Pearson E, Shields B, et al (2020). TriMaster: randomised double-blind crossover study of a DPP4 inhibitor, SGLT2 inhibitor and thiazolidinedione as second-line or third-line therapy in patients with type 2 diabetes who have suboptimal glycaemic control on metformin treatment with or without a sulfonylurea—a MASTERMIND study protocol.
BMJ Open,
10(12), e042784-e042784.
Abstract:
TriMaster: randomised double-blind crossover study of a DPP4 inhibitor, SGLT2 inhibitor and thiazolidinedione as second-line or third-line therapy in patients with type 2 diabetes who have suboptimal glycaemic control on metformin treatment with or without a sulfonylurea—a MASTERMIND study protocol
IntroductionPharmaceutical treatment options for patients with type 2 diabetes mellitus (T2DM) have increased to include multiple classes of oral glucose-lowering agents but without accompanying guidance on which of these may most benefit individual patients. Clinicians lack information for treatment intensification after first-line metformin therapy. Stratifying patients by simple clinical characteristics may improve care by targeting treatment options to those in whom they are most effective. This academically designed and run three-way crossover trial aims to test a stratification approach using three standard oral glucose-lowering agents.Methods and analysisTriMaster is a randomised, double-blind, crossover trial taking place at up to 25 clinical sites across England, Scotland and Wales. 520 patients with T2DM treated with either metformin alone, or metformin and a sulfonylurea who have glycated haemoglobin (HbA1c) >58 mmol/mol will be randomised to receive 16 weeks each of a dipeptidyl peptidase‐4 inhibitor, sodium-glucose co-transporter-2 inhibitor and thiazolidinedione in random order. Participants will be assessed at the end of each treatment period, providing clinical and biochemical data, and their experience of side effects. Participant preference will be assessed on completion of all three treatments. The primary endpoint is HbA1c after 4 months of therapy (allowing a range of 12–18 weeks for analysis). Secondary endpoints include participant-reported preference between the three treatments, tolerability and prevalence of side effects.Ethical approvalThis study was approved by National Health Service Health Research Authority Research Ethics Committee South Central—Oxford A, study 16/SC/0147. Written informed consent will be obtained from all participants. Results will be submitted to a peer-reviewed journal and presented at relevant scientific meetings. A lay summary of results will be made available to all participants.Trial registration numbers12039221; 2015-002790-38 and NCT02653209.
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2019
Rickards NF, Angwin C, Pearson ER, Hattersley AT, Consortium M (2019). Patients choose glucose lowering Type 2 diabetes therapy based on their own tolerability experience rather than glycaemia or weight considerations: Evidence from the blinded TriMaster study.
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2018
Grubb AL, Patel K, Oram RA, Hill AV, Angwin C, McDonald TJ, Weedon MN, Hattersley AT, Owen KR, Shields BM, et al (2018). Development and validation of a clinical prediction model to identify adult patients (aged 18-50) with type 1 diabetes requiring early insulin therapy.
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Shakweh EY, Shields BM, Angwin CD, Rodgers LR, McDonald TJ, Pearson ER, Hattersley AT, Jones AG, Consortium M (2018). Precision medicine in Type 2 diabetes: is variation in response to sitagliptin and gliclazide therapy related to drug levels?.
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2017
Grubb AL, Patel KA, Oram RA, Hill AV, Angwin C, McDonald TJ, Weedon MN, Hattersley AT, Shields BV, Jones AG, et al (2017). Development of a risk calculator to identify patients with Type 1 diabetes who will require early insulin therapy.
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2016
Angwin C, Pearson E, Hattersley A (2016). Crossover studies can help the individualisation of care in type 2 diabetes: the MASTERMIND approach.
Practical Diabetes,
33(4), 115-117.
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Jones AG, Angwin C, Hammersley S, Rogers L, Shields BM, Pearson ER, Hattersley AT (2016). The DPPIV inhibitor sitagliptin lowers postprandial glucose without improving postprandial insulin secretion: a MASTERMIND study.
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2015
Dennis JM, Hattersley AT, Weedon M, Angwin C, Rodgers L, Pearson ER, Henley WE, Shields BM (2015). Development of oedema is associated with an improved glycaemic response in patients initiating thiazolidinediones: a MASTERMIND study.
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Dennis JM, Hattersley AT, Weedon M, Angwin CD, Rodgers L, Pearson ER, Henley WE, Shields BM (2015). Patients who develop oedema on initiating thiazolidinedione therapy have an improved glycaemic response: a MASTERMIND study.
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Rodgers LR, Pearson ER, Hammersley S, Angwin CD, JMcDonald T, Shields BM, Hattersley AT, Jones AG, Consortium MASTERMIND (2015). Patients with a high fasting glucose respond better to sulphonylureas than dipeptidyl peptidase IV (DPP-IV) inhibitors: a MASTERMIND study.
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Rodgers LR, Pearson ER, Angwin CD, Hammersley S, McDonald TJ, Shields BM, Hattersley AT, Jones AG, Consortium M (2015). Response to glucose lowering therapy can be assessed by a brief period of treatment withdrawal: a MASTERMIND study.
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