Comparative effectiveness of once‐weekly glucagon‐like peptide‐1 receptor agonists with regard to 6‐month glycaemic control and weight outcomes in patients with type 2 diabetes

Unni, Sudhir; Wittbrodt, Eric; José, Ma; Schauerhamer, Marisa B.; Hurd, J.; Ruiz‐Negrón, Natalia; McAdam‐Marx, Carrie

doi:10.1111/dom.13107

Cited by 29 publications

(35 citation statements)

References 17 publications

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“…Previous US studies reported 6-month dulaglutide adherence rates of 54% to 57%, 12,21 which are similar to the 6-month adherence rate 13 reported in the present study (59%; Appendix S1, Table S3). Similarly, our observed 6-month adherence rates of 46% for liraglutide and 41%…”

Section: Discussionsupporting

confidence: 89%

Adherence, persistence, glycaemic control and costs among patients with type 2 diabetes initiating dulaglutide compared with liraglutide or exenatide once weekly at 12‐month follow‐up in a real‐world setting in the United States

Mody

Huang

et al. 2019

Diabetes Obesity Metabolism

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Aims To evaluate adherence, persistence, glycaemic control and costs at 12‐month follow‐up for patients initiating dulaglutide versus liraglutide or exenatide once weekly. Materials and methods The present retrospective observational claims study included patients with type 2 diabetes (T2D) and ≥ 1 pharmacy claim for dulaglutide, liraglutide or exenatide once weekly from the HealthCore Integrated Research Database. Adherence was defined as proportion of days covered ≥80%, and persistence was measured by time to discontinuation of index therapy. Change from baseline in glycated haemoglobin (HbA1c) concentration was assessed in a subset with pre‐ and post‐index HbA1c results. Propensity scores were used to match the cohorts. Results The baseline characteristics were balanced for the matched cohorts, dulaglutide versus liraglutide (n = 2471) and dulaglutide versus exenatide once weekly (n = 1891). Among those initiating dulaglutide there was a significantly higher proportion of adherent patients compared with the groups initiating liraglutide (51.2% vs. 38.2%; P < 0.001) and exenatide once weekly (50.7% vs. 31.9%; P < 0.001). At 12 months, 55% of patients in the dulaglutide group versus 43.8% in the liraglutide group (P < 0.001), and 54.9% in the dulaglutide versus 34.4% in the exenatide once‐weekly group (P < 0.001) were persistent. The dulaglutide group had a significantly greater reduction in HbA1c than the liraglutide group (−34.24 vs. −31.94 mmol/mol; P = 0.032), and a greater, but nonsignificant, reduction in HbA1c than the exenatide once‐weekly group (−34.46 vs. −31.94 mmol/mol; P = 0.056). The diabetes‐related total costs were not significantly different between the dulaglutide and the liraglutide group ($16,174 vs. $16,694; P = 0.184), and were significantly higher for dulaglutide than for exenatide once weekly ($15,768 vs. $14,615; P = 0.005). Conclusions Adherence and persistence are important considerations in patient‐centric treatment selection for patients with T2D. Higher adherence and persistence for dulaglutide compared with liraglutide or exenatide once weekly are relevant criteria when choosing glucagon‐like peptide‐1 receptor agonist treatment for patients with T2D.

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Section: Discussionsupporting

confidence: 89%

Adherence, persistence, glycaemic control and costs among patients with type 2 diabetes initiating dulaglutide compared with liraglutide or exenatide once weekly at 12‐month follow‐up in a real‐world setting in the United States

Mody

Huang

et al. 2019

Diabetes Obesity Metabolism

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“…Weight reductions with once-daily liraglutide 1.8 mg were comparable to those with exenatide IR 10 μg twice daily, and significantly greater than those with dulaglutide 1.5 mg/week ( Table 2). The clinical data are supported by results in the real-world setting [24]. In a retrospective cohort study in 2465 patients receiving once-weekly exenatide, dulaglutide or albiglutide, the overall mean decrease from baseline in HbA 1c at 6 months was 0.5%, with no significant differences between treatment groups [24].…”

Section: Comparisons Between Glp-1rasmentioning

confidence: 89%

“…In a retrospective cohort study in 2465 patients receiving once-weekly exenatide, dulaglutide or albiglutide, the overall mean decrease from baseline in HbA 1c at 6 months was 0.5%, with no significant differences between treatment groups [24]. However, weight loss with dulaglutide was significantly better with than with exenatide and albiglutide (2.7 vs 1.4 and 1.6 kg; p = 0.001) [24].…”

Section: Comparisons Between Glp-1rasmentioning

confidence: 99%

Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes: Their Use and Differential Features

Lyseng‐Williamson

2019

Clin Drug Investig

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Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are well established as effective adjuncts to lifestyle modification in the treatment of type 2 diabetes (T2D) as monotherapy or in combination with oral glucose-lowering drugs ± insulin. The six subcutaneous GLP-1RA formulations (i.e. twice-daily exenatide, once-daily liraglutide and lixisenatide, and once-weekly dulaglutide, exenatide and semaglutide) currently available in the EU and USA have many similarities, but also some unique features and properties. By stimulating GLP-1 receptors, GLP-1RAs increase insulin secretion and suppress glucagon release in a glucose-dependent manner, thereby improving clinical and patient-reported outcomes related to glycaemic control and weight. They also have been shown to reduce, or at least not increase, the risk of major cardiovascular outcomes. GLP-1RAs are generally well tolerated, with gastrointestinal and injection-site reactions being the most troublesome drug-related adverse events, and are associated with a very low intrinsic risk of hypoglycaemia. Treatment with GLP-1RAs should be customized to meet the clinical needs and personal preferences of the individual. Enhanced material for this Adis Disease Management article (including translations) can be found at https ://doi.org/10.6084/ m9.figsh are.11320 370.

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“…Other RW studies worldwide have shown similar patients baseline characteristics pointing towards older age and significantly higher BMI as compared to those on clinical trials, yet with a similar HbA1c . These differences, especially regarding BMI, might reflect an unrealistic approach of prescribing physicians based upon the anti‐obesity effect of the class.…”

Section: Discussionmentioning

confidence: 88%

Real‐world GLP‐1 RA therapy in type 2 diabetes: A long‐term effectiveness observational study

Tofé

Argüelles

Mena

et al. 2018

Endocrino Diabet & Metabol

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Summary Aims To evaluate in a real‐world setting the effectiveness and tolerability of available GLP‐1 RA drugs in patients with type 2 diabetes after a prolonged follow‐up. Materials and methods Observational, retrospective, single‐centre study in patients starting GLP‐1 RA therapy. Change in HbA1c, fasting plasma glucose (FPG) and body mass index (BMI) along with gastrointestinal (GI) adverse events and withdrawal from GLP‐1 RA therapy were evaluated. Lack of efficacy of GLP‐1 RA therapy according to prespecified goals was also measured. Results A total of 735 patients were included, mean age 59.7 years, duration of diabetes 9.01 years, HbA1c 8.18% and BMI 38.56 kg/m 2 . Average follow‐up was 18.97 months (range 4.2‐39.09). All HbA1c (0.93%; P < 0.01), FPG (24 mg/dL; P < 0.01) and BMI (1.55 kg/m 2 ; P < 0.05) were significantly reduced from baseline and maintained throughout follow‐up, regardless of prescribed GLP‐1 RA. GI adverse events were present in 13.81% of patients at first follow‐up visit, 37.07% of patients discontinued GLP‐1 RA treatment, and 38.63% did not meet efficacy goals. Conclusions In a real‐world setting, GLP‐1 RA therapy is largely prescribed in severely obese patients with a long‐standing and poorly controlled diabetes. All prescribed GLP‐1 RAs significantly decreased HbA1c, FPG and BMI. GI adverse events affected a low proportion of patients. Inversely, a high proportion of patients did not meet efficacy goals and/or discontinued GLP‐1 RA treatment. Baseline characteristics of patients and lack of adherence may represent important issues underlying differences in effectiveness in real‐world studies versus randomized trials.

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Comparative effectiveness of once‐weekly glucagon‐like peptide‐1 receptor agonists with regard to 6‐month glycaemic control and weight outcomes in patients with type 2 diabetes

Cited by 29 publications

References 17 publications

Adherence, persistence, glycaemic control and costs among patients with type 2 diabetes initiating dulaglutide compared with liraglutide or exenatide once weekly at 12‐month follow‐up in a real‐world setting in the United States

Adherence, persistence, glycaemic control and costs among patients with type 2 diabetes initiating dulaglutide compared with liraglutide or exenatide once weekly at 12‐month follow‐up in a real‐world setting in the United States

Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes: Their Use and Differential Features

Real‐world GLP‐1 RA therapy in type 2 diabetes: A long‐term effectiveness observational study

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