Preference for Oral and Injectable GLP-1 RA Therapy Profiles in Japanese Patients with Type 2 Diabetes: A Discrete Choice Experiment

Igarashi, Ataru; Hansen, Birgit Sehested; Langer, Jörg; Tavella, F; Collings, Hannah; Davies, Neil; Wyn, Robin

doi:10.1007/s12325-020-01561-1

Cited by 26 publications

(28 citation statements)

References 44 publications

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“…Preference for oral over injectable therapies is also well cited in the literature in many other diseases. 33 , 34 …”

Section: Discussionmentioning

confidence: 99%

Patient Preferences for Attributes of Health Canada Approved Weight Loss Medications Among Adults Living with Obesity in Canada: A Qualitative Study

Donnan¹,

Huang²,

Twells³

2022

PPA

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Purpose Obesity is a complex disease with negative impacts on physical and mental health. The treatment of obesity is an area where shared decision making and patient preferences play an important role. Recommendations surrounding weight loss medications are evolving and only recently, with the publication of the 2020 Canadian Obesity Management Clinical Guidelines, pharmacotherapy has become a recommended alternative for obesity management. Guidelines recommend three medications: orlistat, liraglutide, and naltrexone/bupropion. This study sought to identify medication attributes relevant to patients starting pharmacotherapy for weight management. Patients and Methods Semi-structured focus groups and interviews were conducted with Canadian residents who were ≥18 years of age and were living with obesity (body mass index [BMI] ≥30kg/m 2 or ≥27kg/m 2 with adiposity-related complications). Sessions were conducted virtually, audio recorded, and transcribed. Two team members used a combination of inductive and deductive coding to independently code the data. A final coding template was agreed upon through discussion. Results A total of 21 individuals participated (85.7% female, 76.2% ≥40 years of age) with the average BMI being 44.3 kg/m 2 . Participants touched upon many attributes which were categorized into five categories: 1) cost, 2) regimen, 3) side effects, 4) benefits, and 5) non-medication attributes. Cost of medications, lack of coverage by insurance companies, and stigma were identified as major barriers to accessing medications. There was consensus in the desire for a simple regimen, however there was heterogeneity among opinions on tolerability of side effects, desired benefits, and route of administration. Conclusion This study identified attributes that influenced patient’s decisions when considering a new anti-obesity medication. Understanding these attributes can assist clinicians in shared decision-making. This study highlighted the stigma that is prevalent among providers and the need for education. Further research should be conducted to understand the tradeoffs patients in our study make between the identified attributes.

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“…Preference for oral over injectable therapies is also well cited in the literature in many other diseases. 33 , 34 …”

Section: Discussionmentioning

confidence: 99%

Patient Preferences for Attributes of Health Canada Approved Weight Loss Medications Among Adults Living with Obesity in Canada: A Qualitative Study

Donnan¹,

Huang²,

Twells³

2022

PPA

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“…a Lower bound of 95% confidence interval [ 0 for the estimated treatment difference vs dulaglutide 0.75 mg, favoring orally administered semaglutide. ANCOVA analysis of covariance, DTR-QoL Diabetes Therapy-Related Quality of Life have been shown to have a higher preference for an oral, rather than injectable, GLP-1RA drug profile [31]. Orally administered semaglutide has been formulated to address this barrier, but has specific dosing requirements because of the effect of food, liquid, and concomitant medication on its absorption [9].…”

Section: Discussionmentioning

confidence: 99%

“…Individual question scores for this domain indicated concerns around managing injectable treatment and any associated pain or discomfort. The preference for oral therapy among Japanese patients [31] could also have contributed to the durable effect of orally administered semaglutide on HRQoL over 52 weeks, compared with the decline in score observed with dulaglutide. Of note, in the global PIONEER 7 trial, patients answering the Diabetes Treatment Satisfaction Questionnaire reported similar treatment satisfaction with orally administered semaglutide and orally administered sitagliptin after 52 weeks, regardless of the dosing conditions for orally administered semaglutide [23].…”

Section: Discussionmentioning

confidence: 99%

Effect of Orally Administered Semaglutide Versus Dulaglutide on Diabetes-Related Quality of Life in Japanese Patients with Type 2 Diabetes: The PIONEER 10 Randomized, Active-Controlled Trial

Ishii

Hansen

Langer³

2021

Diabetes Ther

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Introduction In the randomized Peptide InnOvatioN for Early diabEtes tReatment (PIONEER) 10 trial, once-daily orally administered semaglutide—the first oral glucagon-like peptide 1 receptor agonist (GLP-1RA)—was similarly tolerated with comparable (at 7 mg) or better (at 14 mg) efficacy versus the injectable GLP-1RA dulaglutide 0.75 mg. Health-related quality of life (HRQoL) in PIONEER 10 was assessed using the Japanese-specific Diabetes Therapy-Related Quality of Life (DTR-QoL) questionnaire. Methods The DTR-QoL comprises 29 questions, providing four domain and total scores. Answers were converted to a score between 0 and 100, with higher scores indicating greater HRQoL. Two estimands were prespecified: treatment policy (regardless of treatment discontinuation or rescue medication use) and trial product (assuming on treatment without rescue medication) in all randomized patients. Outcomes were assessed at weeks 26 and 52. Results Mean baseline DTR-QoL domain scores were similar between treatment arms and were generally lower (giving more scope for improvement) for “anxiety and dissatisfaction with treatment” (62.1–65.3) and “satisfaction with treatment” (53.9–57.9) than “burden on social activities and daily activities” (76.5–77.7) and “hypoglycemia” (83.5–88.2). Using the treatment policy estimand, orally administered semaglutide 7 and 14 mg improved HRQoL versus dulaglutide 0.75 mg for the total score (estimated mean change from baseline [CfB] 7.3 and 8.1 vs 3.3; estimated treatment difference [ETD] 3.9 and 4.8) and the “anxiety and dissatisfaction with treatment” domain (CfB 9.7 and 10.9 vs 3.7; ETD 6.0 and 7.2) at week 52. Orally administered semaglutide 14 mg improved the “satisfaction with treatment” domain versus dulaglutide 0.75 mg (CFB 13.8 vs 5.7; ETD 8.1). DTR-QoL scores for orally administered semaglutide tended to be more durable (sustained over time) than for dulaglutide. Outcomes for the trial product estimand were similar. Conclusion Orally administered semaglutide 7 and 14 mg improved the patients’ HRQoL measured by the Japanese-specific DTR-QoL instrument versus dulaglutide 0.75 mg at week 52. Trial registration ClinicalTrials.gov NCT03015220. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-020-00985-w.

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“…One of the principles of determining attributes in our study was to include as many profiles as the antihyperglycemic drugs. A search of the medical literature was conducted using PubMed, Web of Science and CNKI (Chinese database) to identify any stated preference studies that had been previously published in T2DM ( Gelhorn et al, 2013 ; Purnell et al, 2014 ; von Arx and Kjeer, 2014 ; Donnan et al, 2020 ; Ozdemir et al, 2020 ; Igarashi et al, 2021 ) and the guidelines ( Jia et al, 2019 ; Doyle-Delgado et al, 2020 ; Society, 2021 ) for the prevention and control of T2DM. This literature review helped to generate an initial list of attributes.…”

Section: Methodsmentioning

confidence: 99%

What Is Valued Most by Patients With Type 2 Diabetes Mellitus When Selecting Second-Line Antihyperglycemic Medications in China

Liu

Liu²,

Yu³

et al. 2021

Front. Pharmacol.

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Objective: To estimate patient preferences for second-line antihyperglycemic medications in China.Methods: A face to face survey with the best-worst scaling (BWS) choices was administered in patients with diagnosed type 2 diabetes mellitus (T2DM). Study participants were asked to indicate which attribute they valued most and which attribute they valued least in 11 choice sets, each of which consisted of five alternatives out of 11 antihyperglycemic medication-specific attributes (treatment efficacy, weight change, hypoglycemic events, gastrointestinal side effects, cardiovascular health, urinary tract infection and genital infection side effects, edema, mode of administration, bone fracture, dosing frequency and out-of-pocket cost). A counting approach, a conditional logit model, and K-means clustering were used to estimate the relative importance of items and preference heterogeneity.Results: A total of 362 participants were included with a mean age of 63.6 (standard deviation: 11.8) years. There were 56.4% of participants were women, and 56.3% being diagnosed with diabetes for at least 5 years. Efficacy, cardiovascular health and hypoglycemic events were valued most, while dosing frequency, mode of administration and bone fracture were valued least. The K-means clustering further showed preference heterogeneity in out-of-pocket cost across the participants.Conclusion: Our study suggests that treatment efficacy, cardiovascular health and hypoglycemic events are valued most by Chinese patients with T2DM when selecting second-line antihyperglycemic medications. The study improves the understanding of patients’ preferences for second-line antihyperglycemic medications in China.

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Preference for Oral and Injectable GLP-1 RA Therapy Profiles in Japanese Patients with Type 2 Diabetes: A Discrete Choice Experiment

Cited by 26 publications

References 44 publications

Patient Preferences for Attributes of Health Canada Approved Weight Loss Medications Among Adults Living with Obesity in Canada: A Qualitative Study

Patient Preferences for Attributes of Health Canada Approved Weight Loss Medications Among Adults Living with Obesity in Canada: A Qualitative Study

Effect of Orally Administered Semaglutide Versus Dulaglutide on Diabetes-Related Quality of Life in Japanese Patients with Type 2 Diabetes: The PIONEER 10 Randomized, Active-Controlled Trial

What Is Valued Most by Patients With Type 2 Diabetes Mellitus When Selecting Second-Line Antihyperglycemic Medications in China

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