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In both randomized controlled trials and real-world studies, liraglutide has demonstrated glycemic and body weight benefits in patients with type 2 diabetes. However, persistence with diabetes medication can be challenging. This study compared glycated hemoglobin (HbA1c) and other outcomes in patients with type 2 diabetes who continued treatment with liraglutide for over 12 months with those who discontinued treatment earlier, in a real-life setting.
This is a retrospective study of adult patients with type 2 diabetes from Maccabi Healthcare Services in Israel, who initiated treatment with liraglutide from 2010 to 2015. Mean HbA1c and body weight change from initiation to after 24 months was compared between patients who received liraglutide for at least 12 months (“continuers”) and those who discontinued within the first year (“discontinuers”). Adjustment for HbA1c, body weight, and other potentially confounding factors was performed using 1:1 propensity score matching.
The 3580 patients comprised 2695 continuers and 885 discontinuers; 882 patients per group were matched. A significant (p < 0.001) reduction in HbA1c (– 0.80% vs – 0.32%) was seen in continuers compared with discontinuers, despite higher insulin usage (70.2% vs 59.0%; p < 0.001), and a higher proportion of patients using ≥ 3 oral glucose-lowering drugs (20.6% vs 6.2%; p < 0.001) at 24 months among discontinuers. Mean body weight reduction was greater in continuers than discontinuers (3.57 vs 1.25 kg; p < 0.001).
In a real-world setting, persistent use of liraglutide was associated with good glycemic and body weight control.
Novo Nordisk Health Care AG.
Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterology. 2007;132(6):2131–57. CrossRef
Drucker DJ, Nauck MA. The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. Lancet. 2006;368(9548):1696–705. CrossRef
Garber AJ, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm—2018 executive summary. https://www.aace.com/sites/all/files/diabetes-algorithm-executive-summary.pdf. Accessed 19 Jan 2018.
Jespersen MJ, Knop FK, Christensen M. GLP-1 agonists for type 2 diabetes: pharmacokinetic and toxicological considerations. Expert Opin Drug Metab Toxicol. 2013;9(1):17–29. CrossRef
Neumiller JJ. Differential chemistry (structure), mechanism of action, and pharmacology of GLP-1 receptor agonists and DPP-4 inhibitors. J Am Pharm Assoc. 2003;2009(49 Suppl 1):S16–29.
Monami M, Zannoni S, Pala L, et al. Effects of glucagon-like peptide-1 receptor agonists on mortality and cardiovascular events: a comprehensive meta-analysis of randomized controlled trials. Int J Cardiol. 2017;240:414–21.
Buse JB, Rosenstock J, Sesti G, et al. Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6). Lancet. 2009;374(9683):39–47. CrossRef
Garber A, Henry R, Ratner R, et al. Liraglutide versus glimepiride monotherapy for type 2 diabetes (LEAD-3 Mono): a randomised, 52-week, phase III, double-blind, parallel-treatment trial. Lancet. 2009;373(9662):473–81. CrossRef
Marre M, Shaw J, Brandle M, et al. Liraglutide, a once-daily human GLP-1 analogue, added to a sulphonylurea over 26 weeks produces greater improvements in glycaemic and weight control compared with adding rosiglitazone or placebo in subjects with type 2 diabetes (LEAD-1 SU). Diabet Med. 2009;26(3):268–78.
Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375(19):1834–44. CrossRef
Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311–22. CrossRef
Nauck M, Frid A, Hermansen K, et al. Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin, in type 2 diabetes: the LEAD (Liraglutide Effect and Action in Diabetes)-2 study. Diabetes Care. 2009;32(1):84–90.
Russell-Jones D, Vaag A, Schmitz O, et al. Liraglutide vs insulin glargine and placebo in combination with metformin and sulfonylurea therapy in type 2 diabetes mellitus (LEAD-5 met+SU): a randomised controlled trial. Diabetologia. 2009;52(10):2046–55. CrossRef
Zinman B, Gerich J, Buse JB, et al. Efficacy and safety of the human glucagon-like peptide-1 analog liraglutide in combination with metformin and thiazolidinedione in patients with type 2 diabetes (LEAD-4 Met+TZD). Diabetes Care. 2009;32(7):1224–30. CrossRef
McAdam-Marx C, Nguyen H, Schauerhamer MB, et al. Glycemic control and weight outcomes for exenatide once weekly versus liraglutide in patients with type 2 diabetes: a 1-year retrospective cohort analysis. Clin Ther. 2016;38(12):2642–51. CrossRef
Ostawal A, Mocevic E, Kragh N, et al. Clinical effectiveness of liraglutide in type 2 diabetes treatment in the real-world setting: a systematic literature review. Diabetes Ther. 2016;7(3):411–38. CrossRef
Divino V, DeKoven M, Khan FA, et al. GLP-1 RA treatment patterns among type 2 diabetes patients in five European countries. Diabetes Ther. 2017;8(1):115–28.
Martinez L, Penfornis A, Gautier JF, et al. Effectiveness and persistence of liraglutide treatment among patients with type 2 diabetes treated in primary care and specialist settings: a subgroup analysis from the EVIDENCE study, a prospective, 2-year follow-up, observational, post-marketing study. Adv Ther. 2017;34(3):674–85.
Heymann AD, Chodick G, Halkin H, et al. The implementation of managed care for diabetes using medical informatics in a large preferred provider organization. Diabetes Res Clin Pract. 2006;71(3):290–8.
Heymann A, Maor Y, Goldstein I, et al. Efficacy of liraglutide in a real-life cohort. Diabetes Ther. 2014;5(1):193–206. CrossRef
Chodick G, Heymann AD, Shalev V, et al. The epidemiology of diabetes in a large Israeli HMO. Eur J Epidemiol. 2003;18(12):1143–6. CrossRef
Shalev V, Chodick G, Goren I, et al. The use of an automated patient registry to manage and monitor cardiovascular conditions and related outcomes in a large health organization. Int J Cardiol. 2011;152(3):345–9. CrossRef
Weitzman D, Chodick G, Shalev V, et al. Prevalence and factors associated with resistant hypertension in a large health maintenance organization in Israel. Hypertension. 2014;64(3):501–7. CrossRef
Sawilowsky S. New effect size rules of thumb. J Modern Appl Stat Methods. 2009;8(2):597–9. CrossRef
Parsons LS. Performing a 1:N case-control match on propensity score (paper 165-29). In: Proceedings of SUGI 29; 2004 May 9–12; Montreal, Canada. https://www2.sas.com/proceedings/sugi29/165-29.pdf. Accessed 22 Jan 2018.
Buysman EK, Liu F, Hammer M, et al. Impact of medication adherence and persistence on clinical and economic outcomes in patients with type 2 diabetes treated with liraglutide: a retrospective cohort study. Adv Ther. 2015;32(4):341–55. CrossRef
Yu M, Xie J, Fernandez Lando L, et al. Liraglutide versus exenatide once weekly: persistence, adherence, and early discontinuation. Clin Ther. 2016;38(1):149–60. CrossRef
Lin J, Lingohr-Smith M, Fan T. Real-world medication persistence and outcomes associated with basal insulin and glucagon-like peptide 1 receptor agonist free-dose combination therapy in patients with type 2 diabetes in the US. Clinicoecon Outcomes Res. 2017;9:19–29. CrossRef
Garcia-Perez LE, Alvarez M, Dilla T, et al. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther. 2013;4(2):175–94. CrossRef
Wilke T, Mueller S, Groth A, et al. Non-persistence and non-adherence of patients with type 2 diabetes mellitus in therapy with GLP-1 receptor agonists: a retrospective analysis. Diabetes Ther. 2016;7(1):105–24. CrossRef
Sikirica MV, Martin AA, Wood R, et al. Reasons for discontinuation of GLP1 receptor agonists: data from a real-world cross-sectional survey of physicians and their patients with type 2 diabetes. Diabetes Metab Syndr Obes. 2017;10:403–12. CrossRef
Nguyen H, Dufour R, Caldwell-Tarr A. Glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy adherence for patients with type 2 diabetes in a medicare population. Adv Ther. 2017;34(3):658–73.
Gautier JF, Martinez L, Penfornis A, et al. Effectiveness and persistence with liraglutide among patients with type 2 diabetes in routine clinical practice—EVIDENCE: a prospective, 2-year follow-up, observational, post-marketing study. Adv Ther. 2015;32(9):838–53.
- A Retrospective Database Study of Liraglutide Persistence Associated with Glycemic and Body Weight Control in Patients with Type 2 Diabetes
Lise Lotte N. Husemoen
- Springer Healthcare
Research, treatment and education of diabetes and related disorders
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