Glucagon-Like Peptide-1 Receptor Agonist Treatment Patterns Among Type 2 Diabetes Patients in Six European CountriesReport as inadecuate




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Diabetes Therapy

, Volume 5, Issue 2, pp 499–520

First Online: 04 November 2014Received: 29 August 2014

Abstract

IntroductionThe objective of this study was to evaluate real-world treatment patterns of type 2 diabetes T2D patients initiating glucagon-like peptide-1 receptor agonists GLP-1 RAs in Germany GE, the United Kingdom UK, France FR, the Netherlands NE, Belgium BE, and Sweden SE.

MethodsAdult T2D patients initiating exenatide twice daily exBID, liraglutide once daily LIRA or exenatide once weekly exQW were identified using the IMS LifeLink™ IMS Health, Danbury, CT, USA: Electronic Medical Records EMR; GE-UK-FR and IMS LifeLink™: longitudinal prescriptions LRx; NE-BE-GE-UK databases, and national health register data SE, between 2010 and 2012. Therapy initiation date was termed ‘index date’. Eligible patients had ≥180-day pre- and variable follow-up minimum ≥360-day post-index exBID and LIRA, ≥180-day post-index exQW. Treatment modification and persistence were evaluated over 180 days. Kaplan–Meier KM survival curves and Cox proportional hazards models PHMs; EMR databases only evaluated stopping of the index therapy measured as first of discontinuation or switch.

Results30,206 exBID, 5,401 exQW, and 52,155 LIRA patients were included in the analysis 46.0–66.9% male; mean age range 55.4–59.3 years. Mean follow-up was 20.3–27.4 months for exBID and LIRA, and 7.6–13.9 months for exQW. Across the databases, the proportion experiencing a treatment modification at 180 days was highest among exBID 37.6–81.7% compared to LIRA 36.8–56.6% and exQW 32.3–47.7%. The proportion persistent at 180 days was lowest among exBID patients 46.8–73.5% compared to LIRA 50.6–80.1% or exQW 57.5–74.6%. In the KM analyses, LIRA patients had a lower proportion stopping therapy at all time points compared to exBID patients, across the databases. In the Cox PHMs, LIRA was associated with a significantly lower risk of stopping compared to exBID; in GE, exQW was associated with a lower risk compared to exBID and LIRA.

ConclusionTreatment patterns varied among GLP-1 RA patients, with persistence highest among either LIRA or exQW across countries, and lowest among exBID. Longer-term data would be useful, particularly given limited exQW follow-up due to more recent launch.

KeywordsDatabases Diabetes mellitus Exenatide BID Exenatide QW Glucagon-like peptide 1 Liraglutide Retrospective studies Treatment outcome Type 2-drug therapy Electronic supplementary materialThe online version of this article doi:10.1007-s13300-014-0087-6 contains supplementary material, which is available to authorized users.

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Author: Victoria Divino - Mitch DeKoven - Shawn Hallinan - Nebibe Varol - Sara Bruce Wirta - Won Chan Lee - Matthew Reaney

Source: https://link.springer.com/







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