Poor medication adherence is primarily why RW effectiveness is significantly less than RCT efficacy, suggesting an urgent need to effectively address adherence among patients with type 2 diabetes.

Fewer than two thirds of patients initiated treatment for HR+/HER2- mBC with ET. Among those who did, most received only one line of ET before discontinuation or transition to CT. Patients who received multiple lines of ET experienced shorter durations of therapy with each line. Real-world treatment with ET falls short of the targets recommended by guidelines, representing unmet need for treatment options that improve the effectiveness of endocrine therapy.

SummaryAimsThe study aims to examine real‐world weight change and the role of medication adherence among patients with type 2 diabetes who initiated one of three drug classes: glucagon‐like peptide‐1 receptor agonist (GLP‐1RA), dipeptidyl peptidase‐4 inhibitor (DPP4) and sulfonylureas (SUs).Materials and methodsA cohort of patients initiating one of the three drug classes was selected from a large US database of integrated electronic medical record and administrative claims. Adherence was defined as per cent of days covered ≥80% during the year following drug initiation. Weight change was calculated from drug initiation (−180, +30 d) to 1 year (±90 d) later. Multivariate regression controlled for baseline differences between adherent and poorly adherent patients and the addition of another drug class during follow‐up.ResultsThe study included 833 GLP‐1RA, 2,272 DPP4 and 2,713 SU patients who contributed 2,279, 6,602 and 7,429 observations respectively. Patients initiating a GLP‐1RA achieved the largest weight change (−2.46 kg of GLP‐1RA, −1.26 kg of DPP4 and 0.18 kg of SU, P < 0.01). Adherent GLP‐1 patients lost 1.73 kg more than poorly adherent patients, and adherent SU patients gained 1.11 kg more than poorly adherent patients (all P < 0.01). Adherent and poorly adherent DPP4 patients experienced approximately the same amount of weight loss.ConclusionsMedication adherence can mediate observed weight loss in patients treated with a GLP1‐RA or weight gain in those treated with an SU. Medication adherence was low in a real‐world population, particularly for GLP‐1RA, which displayed the strongest weight loss benefit. Because recent American Diabetes Association guidelines recommend selecting drug therapies that have a weight loss or weight neutral effect for the management of type 2 diabetes patients, patients should be encouraged to enhance their adherence to benefit the most from therapies that have weight loss properties.