Satisfaction and efficacy of switching from daily dipeptidyl peptidase-4 inhibitors to weekly trelagliptin in patients with type 2 diabetes—Randomized controlled study—

Abstract

Abstract. We compared treatment satisfaction between daily dipeptidyl peptidase-4 (DPP-4) inhibitors and a weekly DPP-4 inhibitor in patients with type 2 diabetes. The study was a 12-week, open-label, randomized, multicenter, controlled trial. Participants were Japanese patients with type 2 diabetes who had received daily DPP-4 inhibitors for more than 3 months. Patients were randomly assigned to a treatment cohort: (1) a group that continued taking daily DPP-4 inhibitors (daily group); or (2) a group that switched from daily DPP-4 inhibitors to a weekly DPP-4 inhibitor, trelagliptin (weekly group). The primary outcome was the change in treatment satisfaction levels from baseline to 12 weeks between the two groups, according to Diabetes Treatment Satisfaction Questionnaire (DTSQ) and Diabetes Therapy-Related Quality of Life (DTR-QOL) questionnaire scores. The changes in glycemic control and body weight were also assessed. Of 49 patients initially enrolled in the study, 47 completed the study. The change in DTSQ scores in the weekly group was not significantly different from that in the daily group. However, the improvements in total score and subscale domains 1 and 2 in the DTR-QOL analysis, which relate to burden on social/daily activities and anxiety/dissatisfaction with treatment, were significantly greater in the weekly group than the daily group (p = 0.048, 0.013 and 0.045, respectively). Mean changes in glycated hemoglobin levels and body weight were comparable between the groups. Switching from daily DPP-4 inhibitors to a weekly DPP-4 inhibitor, trelagliptin, could partially improve treatment satisfaction levels in patients with type 2 diabetes without affecting glycemic control.

Randomized Multicenter Evaluation of Quality of Life and Treatment Satisfaction in Type 2 Diabetes Patients Receiving Once-Weekly Trelagliptin Versus a Daily Dipeptidyl Peptidase-4 Inhibitor

“…A study of 14 Japanese patients with T2DM who had stable glycemic control on sitagliptin and were switched to trelagliptin showed that blood glucose levels were either maintained or decreased after the switch to trelagliptin [25], suggesting that patients switched to trelagliptin do not experience deterioration in glycemic control. The results of these and other studies [23, 24] support the results of the present study, which showed that trelagliptin was as effective at improving parameters of glycemic control as daily DPP-4 inhibitor treatment.…”

“…A study in 49 Japanese patients with T2DM who had received daily DPP-4 inhibitors for 3 months and were then continued on daily treatment or switched to trelagliptin for 12 weeks found that the change in DTR-QOL total score significantly improved with trelagliptin versus daily DPP-4 inhibitor treatment, and the subscale analysis also showed significantly greater changes with trelagliptin versus daily DPP-4 inhibitor treatment in domain 1 (burden of social activities/personal activities) and domain 2 (anxiety and dissatisfaction with treatment) [23]. Similar to the present study, there was no significant difference in the change in DTSQ total score between groups [23].…”

“…A study in 49 Japanese patients with T2DM who had received daily DPP-4 inhibitors for 3 months and were then continued on daily treatment or switched to trelagliptin for 12 weeks found that the change in DTR-QOL total score significantly improved with trelagliptin versus daily DPP-4 inhibitor treatment, and the subscale analysis also showed significantly greater changes with trelagliptin versus daily DPP-4 inhibitor treatment in domain 1 (burden of social activities/personal activities) and domain 2 (anxiety and dissatisfaction with treatment) [23]. Similar to the present study, there was no significant difference in the change in DTSQ total score between groups [23]. A potential reason why the results of this study contrasted with the aforementioned study in terms of the DTR-QOL result is that the patients in the present study were treatment naïve, and thus had no previous regimen for comparison, while the patients in the aforementioned study had been taking daily DPP-4 inhibitors for 3 months, which allowed them to fully experience both the daily and weekly regimens.…”

Treatment patterns, persistence and adherence rates in patients with type 2 diabetes mellitus in Japan: a claims-based cohort study

“…The PREFERENCE 4 study documented that treatment-naive Japanese patients preferred (in terms of treatment satisfaction) a DPP-4i to a BG, SU, or α-GI 26. Use of a weekly DPP-4i also improved treatment satisfaction 27 28. However, these are preliminary findings, and additional real-world data from other DPP-4i studies are awaited.…”

Effects of the Once-Weekly DPP4 Inhibitor Omarigliptin on Glycemic Control in Patients with Type 2 Diabetes Mellitus on Maintenance Hemodialysis: A 24-Week Open-Label, Multicenter Randomized Controlled Study

“…Some studies have reported improved treatment satisfaction when patients with T2DM switched from once-daily to once-weekly drugs, based on the Diabetes Treatment Satisfaction Questionnaire [23]. The DTR-QOL instrument that we used is an exact reflection of the patient's satisfaction with treatment, especially in relatively younger patients under the age of 65 years [24], those receiving at most two concomitant drugs for treatment of comorbidities, and those who were treatment naïve before the start of the study [25]. As such, we expected some improvement in patient satisfaction with treatment, but there was no significant improvement in DTR-QOL score in the omarigliptin group.…”