Utilization Patterns of Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus in Italy: A Retrospective Cohort Study.

Federici, Marco Orsini McQuillan, Janette Biricolti, Giovanni Losi, Serena Lebrec, Jeremie Richards, Catrina Miglio, Cristiana Norrbacka, Kirsi

REVIEW


09 July 2018

This study is not particularly innovative nor is it particularly surprising that twice-daily injections infer lower persistence than weekly doses. However, it does have some clinical relevance. I would have liked to have seen a separate comparison of short-acting and longer acting GLP-1RAs rather than simply grouping them together.


RELEVANCE 1
INNOVATIVENESS 3
APPLICABILITY 4
OVERALL 3

PAPER DETAILS


TITLE

Utilization Patterns of Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus in Italy: A Retrospective Cohort Study.

ABSTRACT

INTRODUCTION
Real-world evidence on glucagon-like peptide-1 receptor agonist (GLP-1 RAs) usage is emerging in different European countries but is lacking in Italy. This retrospective cohort study aimed to describe the real-world drug utilization patterns in patients initiating GLP-1 RAs for treating T2DM in Italy.

METHODS
Adults aged ≥ 20 years and with ≥ 1 oral antidiabetic drug (alone or in combination with insulin) other than GLP-1 RAs in the 6 months prior to initiating exenatide twice daily (exBID), exenatide once weekly (exQW), dulaglutide once weekly (DULA), liraglutide once daily (LIRA) or lixisenatide once daily (LIXI) between March and July 2016 were retrospectively identified in the Italian IMS LifeLink™ longitudinal prescriptions database (retail pharmacy data). Patients with ≥ 6-month follow-up (defined as evidence of any prescription activity) were included. Proportions of patients who remained persistent (continued treatment until discontinuation/switch) in the first 6 months and of those who discontinued or switched to a different GLP-1 RA over the entire follow-up were recorded. For each treatment, the average daily/weekly dosage (ADD/AWD) while persistent during the available follow-up was calculated.

RESULTS
We identified 7319 patients: 92 exBID, 970 exQW, 3368 DULA, 2573 LIRA and 316 LIXI. Across treatments, 89% patients were ≥ 50 years old, 54% were males, and the median follow-up duration ranged between 8.1 and 8.7 months. At 6 months, 35% exBID, 47% exQW, 62% DULA, 50% LIRA and 40% LIXI patients remained persistent. Over the entire follow-up, median persistence days varied from 73 (exBID) to > 300 days (DULA). The mean ± SD ADD/AWD was exBID: 17.7 ± 2.1 µg/day; exQW: 2.1 ± 0.1 mg/week; DULA: 1.5 ± 0.2 mg/week; LIRA: 1.5 ± 0.2 mg/day; LIXI: 21.0 ± 5.5 µg/day.

CONCLUSIONS
This real-world analysis suggests differences exist in persistence between patients treated with various GLP-1 RAs. Among the investigated treatments, patients prescribed exBID recorded the lowest and those prescribed DULA the highest persistence with therapy.

FUNDING
Eli Lilly and Co., Indianapolis, IN, USA.



AUTHOR(S)

Federici, Marco Orsini McQuillan, Janette Biricolti, Giovanni Losi, Serena Lebrec, Jeremie Richards, Catrina Miglio, Cristiana Norrbacka, Kirsi

JOURNAL

Diabetes therapy : research, treatment and education of diabetes and related disorders

PLACE

United States