Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain
Introduction This study aimed to describe utilization patterns, persistence, resource utilization and costs in patients with type 2 diabetes mellitus initiating treatment with glucagon-like peptide 1 receptor agonists in routine clinical practice in Spain. Methods This retrospective study of medical...
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| Veröffentlicht in: | Diabetes therapy 2021-05, Vol.12 (5), p.1535-1551 |
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| description | Introduction
This study aimed to describe utilization patterns, persistence, resource utilization and costs in patients with type 2 diabetes mellitus initiating treatment with glucagon-like peptide 1 receptor agonists in routine clinical practice in Spain.
Methods
This retrospective study of medical records in the Big-Pac database identified adults starting treatment with once-weekly (QW) dulaglutide, exenatide-QW or once-daily liraglutide between 1 November 2015 and 30 June 2017. Patients were followed for up to 18 months from treatment initiation. Data on clinical characteristics of patients, treatment patterns, average daily dose and costs were obtained for the three cohorts. Persistence over the 18-month period was evaluated using Kaplan–Meier curves. All analyses were descriptive.
Results
A total of 1402 patients were included in this study (dulaglutide [
n
= 492], exenatide-QW [
n
= 438] or liraglutide [
n
= 472]); 52.8% were men, and the mean (SD) age was 62 (11) years, glycated haemoglobin (HbA1c) was 8.1% (1.2) and body mass index was 35.5 (3.2) kg/m
2
at treatment initiation. Persistence at 18 months was 59.1% (95% confidence interval [CI] 54.8–63.4) for dulaglutide, 45.7% (95% CI 41.0–50.4) for exenatide-QW and 46.6% (95% CI 42.1–51.1) for liraglutide. The average (SD) dose was 1.2 (0.4) mg/week for dulaglutide, 1.9 (0.3) mg/week for exenatide-QW and 1.1 (0.3) mg/day for liraglutide. The average reduction in HbA1c levels at 1 year was − 0.68% for patients who initiated dulaglutide, − 0.54% for patients who initiated exenatide-QW and − 0.50% for patients who initiated liraglutide. The mean (SD) total annual health care costs were €4072 (1946) for dulaglutide, €4418 (2382) for exenatide-QW and €4382 (2389) for liraglutide.
Conclusion
Results suggest that patients who started treatment with dulaglutide had higher persistence over 18 months, presented lower HbA1c levels at 12 months and incurred lower annual total healthcare costs than patients who initiated exenatide-QW or liraglutide.
Plain Language Summary
Type 2 diabetes has a major impact on patients psychologically and socially, as well as on healthcare costs. The glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are drugs that help maintain blood sugar at healthy levels. They are often used as the first injectable drugs if oral treatments are no longer effective. This study aimed to analyse the use of GLP-1 RAs, and the costs involved, among patients with type 2 diabetes who started tr |
| doi_str_mv | 10.1007/s13300-021-01039-5 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8099971</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A660897916</galeid><sourcerecordid>A660897916</sourcerecordid><originalsourceid>FETCH-LOGICAL-c541t-63f4ef7e838f47113457b5fb20e3eda0fdc087c94ec4eead96523048a1c16133</originalsourceid><addsrcrecordid>eNp9Ut1qFDEYHcRiS9sX8EIC3ngzNX-TSbwQllarsKLYBS9DNvNlTZ1NpsmMsG_js_hkZrt1a0VMLvLznXM-zsepqqcEnxGM25eZMIZxjSmpMcFM1c2j6ohIoWqhBHm8vzfssDrN-RqXxZRShDypDhmTAivaHlXhsp-sWcVQz_03QJ9gGH0HP38Q9BlsecSEZqXq85iRD2ixGUqRogtvljBCRh-g7_045VfowowGuRTXyBSu6esvMfUduhqnbrOlXg3Gh5PqwJk-w-ndeVwt3r5ZnL-r5x8v35_P5rVtOBlrwRwH14Jk0vGWEMabdtm4JcXAoDPYdRbL1ioOlgOYTomGMsylIZaIMpjj6vVOdpiWa-gshDGZXg_Jr03a6Gi8flgJ_qtexe9a4jKilhSBF3cCKd5MkEe99tkWryZAnLKmDeECc3rb6_lf0Os4pVDcaaqYJBy3kt6jVqYH7YOLpa_diuqZEFiqVhFRUGf_QJXdwdrbGMD58v-AQHcEm2LOCdzeI8F6mxO9y4kuOdG3OdFNIT37czp7yu9UFADbAXIphRWke0v_kf0FirHHxA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2938140782</pqid></control><display><type>article</type><title>Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain</title><source>DOAJ Directory of Open Access Journals</source><source>Springer Nature OA Free Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Norrbacka, Kirsi ; Sicras-Mainar, Antoni ; Lebrec, Jeremie ; Artime, Esther ; Díaz, Silvia ; Tofé-Povedano, Santiago ; Hernández, Ignacio ; Romera, Irene</creator><creatorcontrib>Norrbacka, Kirsi ; Sicras-Mainar, Antoni ; Lebrec, Jeremie ; Artime, Esther ; Díaz, Silvia ; Tofé-Povedano, Santiago ; Hernández, Ignacio ; Romera, Irene</creatorcontrib><description>Introduction
This study aimed to describe utilization patterns, persistence, resource utilization and costs in patients with type 2 diabetes mellitus initiating treatment with glucagon-like peptide 1 receptor agonists in routine clinical practice in Spain.
Methods
This retrospective study of medical records in the Big-Pac database identified adults starting treatment with once-weekly (QW) dulaglutide, exenatide-QW or once-daily liraglutide between 1 November 2015 and 30 June 2017. Patients were followed for up to 18 months from treatment initiation. Data on clinical characteristics of patients, treatment patterns, average daily dose and costs were obtained for the three cohorts. Persistence over the 18-month period was evaluated using Kaplan–Meier curves. All analyses were descriptive.
Results
A total of 1402 patients were included in this study (dulaglutide [
n
= 492], exenatide-QW [
n
= 438] or liraglutide [
n
= 472]); 52.8% were men, and the mean (SD) age was 62 (11) years, glycated haemoglobin (HbA1c) was 8.1% (1.2) and body mass index was 35.5 (3.2) kg/m
2
at treatment initiation. Persistence at 18 months was 59.1% (95% confidence interval [CI] 54.8–63.4) for dulaglutide, 45.7% (95% CI 41.0–50.4) for exenatide-QW and 46.6% (95% CI 42.1–51.1) for liraglutide. The average (SD) dose was 1.2 (0.4) mg/week for dulaglutide, 1.9 (0.3) mg/week for exenatide-QW and 1.1 (0.3) mg/day for liraglutide. The average reduction in HbA1c levels at 1 year was − 0.68% for patients who initiated dulaglutide, − 0.54% for patients who initiated exenatide-QW and − 0.50% for patients who initiated liraglutide. The mean (SD) total annual health care costs were €4072 (1946) for dulaglutide, €4418 (2382) for exenatide-QW and €4382 (2389) for liraglutide.
Conclusion
Results suggest that patients who started treatment with dulaglutide had higher persistence over 18 months, presented lower HbA1c levels at 12 months and incurred lower annual total healthcare costs than patients who initiated exenatide-QW or liraglutide.
Plain Language Summary
Type 2 diabetes has a major impact on patients psychologically and socially, as well as on healthcare costs. The glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are drugs that help maintain blood sugar at healthy levels. They are often used as the first injectable drugs if oral treatments are no longer effective. This study aimed to analyse the use of GLP-1 RAs, and the costs involved, among patients with type 2 diabetes who started treatment with once-weekly dulaglutide, once-weekly exenatide or liraglutide in routine clinical practice in Spain. An electronic database of medical records was used to obtain data from 1402 patients who started treatment with these drugs and were followed for a 1.5-year period. Results of this study suggest that patients who were prescribed dulaglutide stayed on their treatment longer and could reduce their blood sugar levels more efficiently, and at a lower cost, than those who received once-weekly exenatide or liraglutide. These findings could be helpful to physicians prescribing these drugs when considering how to improve the management of type 2 diabetes.</description><identifier>ISSN: 1869-6953</identifier><identifier>EISSN: 1869-6961</identifier><identifier>DOI: 10.1007/s13300-021-01039-5</identifier><identifier>PMID: 33860927</identifier><language>eng</language><publisher>Cheshire: Springer Healthcare</publisher><subject>Cardiology ; Clinical medicine ; Costs ; Diabetes ; Diabetes therapy ; Dosage and administration ; Drug dosages ; Drug therapy ; Endocrinology ; Evaluation ; Exenatide ; Forecasts and trends ; GLP-1 receptor agonists ; Glucagon ; Health care expenditures ; Internal Medicine ; Liraglutide ; Management ; Medical care, Cost of ; Medical records ; Medicine ; Medicine & Public Health ; Original Research ; Peptides ; Prescription drugs ; Type 2 diabetes</subject><ispartof>Diabetes therapy, 2021-05, Vol.12 (5), p.1535-1551</ispartof><rights>The Author(s) 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-63f4ef7e838f47113457b5fb20e3eda0fdc087c94ec4eead96523048a1c16133</citedby><cites>FETCH-LOGICAL-c541t-63f4ef7e838f47113457b5fb20e3eda0fdc087c94ec4eead96523048a1c16133</cites><orcidid>0000-0002-8308-3088</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099971/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099971/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,27907,27908,41103,42172,51559,53774,53776</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33860927$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Norrbacka, Kirsi</creatorcontrib><creatorcontrib>Sicras-Mainar, Antoni</creatorcontrib><creatorcontrib>Lebrec, Jeremie</creatorcontrib><creatorcontrib>Artime, Esther</creatorcontrib><creatorcontrib>Díaz, Silvia</creatorcontrib><creatorcontrib>Tofé-Povedano, Santiago</creatorcontrib><creatorcontrib>Hernández, Ignacio</creatorcontrib><creatorcontrib>Romera, Irene</creatorcontrib><title>Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain</title><title>Diabetes therapy</title><addtitle>Diabetes Ther</addtitle><addtitle>Diabetes Ther</addtitle><description>Introduction
This study aimed to describe utilization patterns, persistence, resource utilization and costs in patients with type 2 diabetes mellitus initiating treatment with glucagon-like peptide 1 receptor agonists in routine clinical practice in Spain.
Methods
This retrospective study of medical records in the Big-Pac database identified adults starting treatment with once-weekly (QW) dulaglutide, exenatide-QW or once-daily liraglutide between 1 November 2015 and 30 June 2017. Patients were followed for up to 18 months from treatment initiation. Data on clinical characteristics of patients, treatment patterns, average daily dose and costs were obtained for the three cohorts. Persistence over the 18-month period was evaluated using Kaplan–Meier curves. All analyses were descriptive.
Results
A total of 1402 patients were included in this study (dulaglutide [
n
= 492], exenatide-QW [
n
= 438] or liraglutide [
n
= 472]); 52.8% were men, and the mean (SD) age was 62 (11) years, glycated haemoglobin (HbA1c) was 8.1% (1.2) and body mass index was 35.5 (3.2) kg/m
2
at treatment initiation. Persistence at 18 months was 59.1% (95% confidence interval [CI] 54.8–63.4) for dulaglutide, 45.7% (95% CI 41.0–50.4) for exenatide-QW and 46.6% (95% CI 42.1–51.1) for liraglutide. The average (SD) dose was 1.2 (0.4) mg/week for dulaglutide, 1.9 (0.3) mg/week for exenatide-QW and 1.1 (0.3) mg/day for liraglutide. The average reduction in HbA1c levels at 1 year was − 0.68% for patients who initiated dulaglutide, − 0.54% for patients who initiated exenatide-QW and − 0.50% for patients who initiated liraglutide. The mean (SD) total annual health care costs were €4072 (1946) for dulaglutide, €4418 (2382) for exenatide-QW and €4382 (2389) for liraglutide.
Conclusion
Results suggest that patients who started treatment with dulaglutide had higher persistence over 18 months, presented lower HbA1c levels at 12 months and incurred lower annual total healthcare costs than patients who initiated exenatide-QW or liraglutide.
Plain Language Summary
Type 2 diabetes has a major impact on patients psychologically and socially, as well as on healthcare costs. The glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are drugs that help maintain blood sugar at healthy levels. They are often used as the first injectable drugs if oral treatments are no longer effective. This study aimed to analyse the use of GLP-1 RAs, and the costs involved, among patients with type 2 diabetes who started treatment with once-weekly dulaglutide, once-weekly exenatide or liraglutide in routine clinical practice in Spain. An electronic database of medical records was used to obtain data from 1402 patients who started treatment with these drugs and were followed for a 1.5-year period. Results of this study suggest that patients who were prescribed dulaglutide stayed on their treatment longer and could reduce their blood sugar levels more efficiently, and at a lower cost, than those who received once-weekly exenatide or liraglutide. These findings could be helpful to physicians prescribing these drugs when considering how to improve the management of type 2 diabetes.</description><subject>Cardiology</subject><subject>Clinical medicine</subject><subject>Costs</subject><subject>Diabetes</subject><subject>Diabetes therapy</subject><subject>Dosage and administration</subject><subject>Drug dosages</subject><subject>Drug therapy</subject><subject>Endocrinology</subject><subject>Evaluation</subject><subject>Exenatide</subject><subject>Forecasts and trends</subject><subject>GLP-1 receptor agonists</subject><subject>Glucagon</subject><subject>Health care expenditures</subject><subject>Internal Medicine</subject><subject>Liraglutide</subject><subject>Management</subject><subject>Medical care, Cost of</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Research</subject><subject>Peptides</subject><subject>Prescription drugs</subject><subject>Type 2 diabetes</subject><issn>1869-6953</issn><issn>1869-6961</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9Ut1qFDEYHcRiS9sX8EIC3ngzNX-TSbwQllarsKLYBS9DNvNlTZ1NpsmMsG_js_hkZrt1a0VMLvLznXM-zsepqqcEnxGM25eZMIZxjSmpMcFM1c2j6ohIoWqhBHm8vzfssDrN-RqXxZRShDypDhmTAivaHlXhsp-sWcVQz_03QJ9gGH0HP38Q9BlsecSEZqXq85iRD2ixGUqRogtvljBCRh-g7_045VfowowGuRTXyBSu6esvMfUduhqnbrOlXg3Gh5PqwJk-w-ndeVwt3r5ZnL-r5x8v35_P5rVtOBlrwRwH14Jk0vGWEMabdtm4JcXAoDPYdRbL1ioOlgOYTomGMsylIZaIMpjj6vVOdpiWa-gshDGZXg_Jr03a6Gi8flgJ_qtexe9a4jKilhSBF3cCKd5MkEe99tkWryZAnLKmDeECc3rb6_lf0Os4pVDcaaqYJBy3kt6jVqYH7YOLpa_diuqZEFiqVhFRUGf_QJXdwdrbGMD58v-AQHcEm2LOCdzeI8F6mxO9y4kuOdG3OdFNIT37czp7yu9UFADbAXIphRWke0v_kf0FirHHxA</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Norrbacka, Kirsi</creator><creator>Sicras-Mainar, Antoni</creator><creator>Lebrec, Jeremie</creator><creator>Artime, Esther</creator><creator>Díaz, Silvia</creator><creator>Tofé-Povedano, Santiago</creator><creator>Hernández, Ignacio</creator><creator>Romera, Irene</creator><general>Springer Healthcare</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8308-3088</orcidid></search><sort><creationdate>20210501</creationdate><title>Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain</title><author>Norrbacka, Kirsi ; Sicras-Mainar, Antoni ; Lebrec, Jeremie ; Artime, Esther ; Díaz, Silvia ; Tofé-Povedano, Santiago ; Hernández, Ignacio ; Romera, Irene</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-63f4ef7e838f47113457b5fb20e3eda0fdc087c94ec4eead96523048a1c16133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cardiology</topic><topic>Clinical medicine</topic><topic>Costs</topic><topic>Diabetes</topic><topic>Diabetes therapy</topic><topic>Dosage and administration</topic><topic>Drug dosages</topic><topic>Drug therapy</topic><topic>Endocrinology</topic><topic>Evaluation</topic><topic>Exenatide</topic><topic>Forecasts and trends</topic><topic>GLP-1 receptor agonists</topic><topic>Glucagon</topic><topic>Health care expenditures</topic><topic>Internal Medicine</topic><topic>Liraglutide</topic><topic>Management</topic><topic>Medical care, Cost of</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Research</topic><topic>Peptides</topic><topic>Prescription drugs</topic><topic>Type 2 diabetes</topic><toplevel>online_resources</toplevel><creatorcontrib>Norrbacka, Kirsi</creatorcontrib><creatorcontrib>Sicras-Mainar, Antoni</creatorcontrib><creatorcontrib>Lebrec, Jeremie</creatorcontrib><creatorcontrib>Artime, Esther</creatorcontrib><creatorcontrib>Díaz, Silvia</creatorcontrib><creatorcontrib>Tofé-Povedano, Santiago</creatorcontrib><creatorcontrib>Hernández, Ignacio</creatorcontrib><creatorcontrib>Romera, Irene</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Norrbacka, Kirsi</au><au>Sicras-Mainar, Antoni</au><au>Lebrec, Jeremie</au><au>Artime, Esther</au><au>Díaz, Silvia</au><au>Tofé-Povedano, Santiago</au><au>Hernández, Ignacio</au><au>Romera, Irene</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain</atitle><jtitle>Diabetes therapy</jtitle><stitle>Diabetes Ther</stitle><addtitle>Diabetes Ther</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>12</volume><issue>5</issue><spage>1535</spage><epage>1551</epage><pages>1535-1551</pages><issn>1869-6953</issn><eissn>1869-6961</eissn><abstract>Introduction
This study aimed to describe utilization patterns, persistence, resource utilization and costs in patients with type 2 diabetes mellitus initiating treatment with glucagon-like peptide 1 receptor agonists in routine clinical practice in Spain.
Methods
This retrospective study of medical records in the Big-Pac database identified adults starting treatment with once-weekly (QW) dulaglutide, exenatide-QW or once-daily liraglutide between 1 November 2015 and 30 June 2017. Patients were followed for up to 18 months from treatment initiation. Data on clinical characteristics of patients, treatment patterns, average daily dose and costs were obtained for the three cohorts. Persistence over the 18-month period was evaluated using Kaplan–Meier curves. All analyses were descriptive.
Results
A total of 1402 patients were included in this study (dulaglutide [
n
= 492], exenatide-QW [
n
= 438] or liraglutide [
n
= 472]); 52.8% were men, and the mean (SD) age was 62 (11) years, glycated haemoglobin (HbA1c) was 8.1% (1.2) and body mass index was 35.5 (3.2) kg/m
2
at treatment initiation. Persistence at 18 months was 59.1% (95% confidence interval [CI] 54.8–63.4) for dulaglutide, 45.7% (95% CI 41.0–50.4) for exenatide-QW and 46.6% (95% CI 42.1–51.1) for liraglutide. The average (SD) dose was 1.2 (0.4) mg/week for dulaglutide, 1.9 (0.3) mg/week for exenatide-QW and 1.1 (0.3) mg/day for liraglutide. The average reduction in HbA1c levels at 1 year was − 0.68% for patients who initiated dulaglutide, − 0.54% for patients who initiated exenatide-QW and − 0.50% for patients who initiated liraglutide. The mean (SD) total annual health care costs were €4072 (1946) for dulaglutide, €4418 (2382) for exenatide-QW and €4382 (2389) for liraglutide.
Conclusion
Results suggest that patients who started treatment with dulaglutide had higher persistence over 18 months, presented lower HbA1c levels at 12 months and incurred lower annual total healthcare costs than patients who initiated exenatide-QW or liraglutide.
Plain Language Summary
Type 2 diabetes has a major impact on patients psychologically and socially, as well as on healthcare costs. The glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are drugs that help maintain blood sugar at healthy levels. They are often used as the first injectable drugs if oral treatments are no longer effective. This study aimed to analyse the use of GLP-1 RAs, and the costs involved, among patients with type 2 diabetes who started treatment with once-weekly dulaglutide, once-weekly exenatide or liraglutide in routine clinical practice in Spain. An electronic database of medical records was used to obtain data from 1402 patients who started treatment with these drugs and were followed for a 1.5-year period. Results of this study suggest that patients who were prescribed dulaglutide stayed on their treatment longer and could reduce their blood sugar levels more efficiently, and at a lower cost, than those who received once-weekly exenatide or liraglutide. These findings could be helpful to physicians prescribing these drugs when considering how to improve the management of type 2 diabetes.</abstract><cop>Cheshire</cop><pub>Springer Healthcare</pub><pmid>33860927</pmid><doi>10.1007/s13300-021-01039-5</doi><tpages>17</tpages><orcidid>https://orcid.org/0000-0002-8308-3088</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Diabetes therapy, 2021-05, Vol.12 (5), p.1535-1551 |
| issn | 1869-6953 1869-6961 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8099971 |
| source | DOAJ Directory of Open Access Journals; Springer Nature OA Free Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Cardiology Clinical medicine Costs Diabetes Diabetes therapy Dosage and administration Drug dosages Drug therapy Endocrinology Evaluation Exenatide Forecasts and trends GLP-1 receptor agonists Glucagon Health care expenditures Internal Medicine Liraglutide Management Medical care, Cost of Medical records Medicine Medicine & Public Health Original Research Peptides Prescription drugs Type 2 diabetes |
| title | Glucagon-Like Peptide 1 Receptor Agonists in Type 2 Diabetes Mellitus: Data from a Real-World Study in Spain |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-17T03%3A45%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Glucagon-Like%20Peptide%C2%A01%20Receptor%20Agonists%20in%20Type%C2%A02%20Diabetes%20Mellitus:%20Data%20from%20a%20Real-World%20Study%20in%20Spain&rft.jtitle=Diabetes%20therapy&rft.au=Norrbacka,%20Kirsi&rft.date=2021-05-01&rft.volume=12&rft.issue=5&rft.spage=1535&rft.epage=1551&rft.pages=1535-1551&rft.issn=1869-6953&rft.eissn=1869-6961&rft_id=info:doi/10.1007/s13300-021-01039-5&rft_dat=%3Cgale_pubme%3EA660897916%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2938140782&rft_id=info:pmid/33860927&rft_galeid=A660897916&rfr_iscdi=true |