Glycemic Control and Weight Outcomes for Exenatide Once Weekly Versus Liraglutide in Patients with Type 2 Diabetes: A 1-Year Retrospective Cohort Analysis
| Autor: | Sudhir Unni, Carrie McAdam-Marx, Xiangyang Ye, Marisa B. Schauerhamer, Hiep Nguyen, Mukul Singhal, David Cobden |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty endocrine system diseases exenatide medicine.medical_treatment 030209 endocrinology & metabolism Type 2 diabetes 030204 cardiovascular system & hematology Glucagon-Like Peptide-1 Receptor 03 medical and health sciences 0302 clinical medicine Weight loss Internal medicine Diabetes mellitus medicine Humans Hypoglycemic Agents Insulin Pharmacology (medical) Retrospective Studies Glycemic Glycated Hemoglobin Pharmacology liraglutide Venoms business.industry Liraglutide Body Weight weight Retrospective cohort study Middle Aged medicine.disease Surgery Diabetes Mellitus Type 2 diabetes mellitus glycemic control Female observational study medicine.symptom Peptides business Exenatide medicine.drug |
| Zdroj: | Clinical Therapeutics. 38:2642-2651 |
| ISSN: | 0149-2918 |
| DOI: | 10.1016/j.clinthera.2016.11.003 |
| Popis: | Purpose Data comparing real-world effectiveness of the glucagon-like peptide-1 receptor agonists (GLP-1RAs) exenatide once weekly (QW) and liraglutide in the treatment of type 2 diabetes (T2D) are limited. Furthermore, there is limited information on exenatide QW or liraglutide response by glycemic control and insulin use status. This study identifies 1-year glycosylated hemoglobin (HbA 1c ) and weight outcomes with exenatide QW and liraglutide in the real-world setting overall and in insulin-naive patients with uncontrolled T2D. Methods This retrospective cohort study using national electronic medical record data compared 1-year HbA 1c and weight outcomes in patients with T2D prescribed exenatide QW or liraglutide. Included patients were adults (≥18 years old) with T2D who were GLP-1RA naive when newly prescribed exenatide QW or liraglutide between January 1, 2012, and March 31, 2013 (index date). Outcomes were reported descriptively overall and in subsets of insulin-naive patients with baseline HbA 1c ≥7.0% or ≥9.0%. Multivariable linear regression analyses were performed to estimate adjusted change in HbA 1c and weight. Findings The study included 808 exenatide QW and 4333 liraglutide patients. Mean (SD) age was 57 (11) years in both groups. Mean baseline HbA 1c was 8.3% (1.5%) in exenatide QW patients and 8.4% (1.6%) in liraglutide patients ( P = 0.66); 16 (2%) of the exenatide QW and 1099 (25.4%) of the liraglutide patients were newly prescribed insulin on the index date ( P 1c change at 1 year was −0.37% (95% CI, −0.53% to −0.21%) for exenatide QW and −0.37% (95% CI, −0.55% to −0.18%) for liraglutide. Adjusted HbA 1c reduction was more pronounced in insulin-naive patients with baseline HbA 1c ≥7.0% (−0.71% and −0.80% for the exenatide QW and liraglutide patients, respectively, P > 0.05) and ≥9.0% (−1.73% and −1.57% for exenatide QW and liraglutide patients, respectively, P > 0.05). Mean (adjusted) weight loss was −2.22 kg (95% CI, −3.06 to −1.37 kg) with exenatide QW and −2.21 kg (95% CI, −3.18 to −1.23 kg) with liraglutide. Implications Exenatide QW and liraglutide lead to similar HbA 1c and weight reductions at 1 year in the real-world setting. Greater HbA 1c reductions occurred in insulin-naive patients with baseline HbA 1c ≥7.0%. Both agents are appropriate options for patients needing antidiabetes therapy to lower HbA 1c while promoting weight loss. |
| Databáze: | OpenAIRE |
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