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

Abstract

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.

Assessing patient PREFERence between the dulaglutide pen and the semaglutide pen: A crossover study (PREFER)

“…A growing body of literature has examined patient preferences among glucagon‐like peptide‐1 (GLP‐1) receptor agonists, which are often recommended for glycaemic control in patients with T2D . Medications in this class have been shown to have efficacy for lowering HbA1c with a low risk of hypoglycaemia and a potential benefit of weight loss . One of the most commonly prescribed weekly GLP‐1 receptor agonists is dulaglutide, which showed efficacy and safety in the AWARD clinical trial programme and the REWIND trial focusing on cardiovascular outcomes .…”

“…2 Medications in this class have been shown to have efficacy for lowering HbA1c with a low risk of hypoglycaemia and a potential benefit of weight loss. [11][12][13][14] One of the most commonly prescribed weekly GLP-1 receptor agonists is dulaglutide, which showed efficacy and safety in the AWARD clinical trial programme [15][16][17][18][19][20][21][22][23][24][25] and the REWIND trial focusing on cardiovascular outcomes. 26 Injectable semaglutide is a newer GLP-1 receptor agonist that has shown efficacy and safety in the SUSTAIN clinical trial programme 20,[27][28][29][30][31] and a trial focusing on cardiovascular safety.…”

Comparative Effectiveness of Dulaglutide Versus Iiraglutide in Asian type 2 Diabetes Patients: A Multi-Institutional Cohort Study and Meta-Analysis

“…3. We excluded one study [13] with less than 6 months of follow-up and three studies [8,12,14] without su cient outcome data. The characteristics of the included studies are provided in Appendix Table 4.…”

Stationäre Therapie des Typ-2-Diabetes

“…Fer-ner sollte bedacht werden, dass die theoretische Effektivität vieler blutzuckersenkender Medikamente in der klinischen Praxis erheblich durch das jeweilige Nebenwirkungsspektrum und die daraus resultierende geringe Adhärenz beeinträchtigt wird. So zeigen aktuelle Erhebungen, dass beispielsweise eine Therapie mit GLP-1-Rezeptoragonisten bei bis zu 40 % der Patienten nach einem Jahr beendet wird [4,5]. Eine Ursache könnten gastrointestinale Unverträglichkeiten sein.…”