Background: GLP-1 RAs are an injectable class of medications with demonstrated weight loss in clinical trials. However, weight changes related to GLP-1RA use have not been well-characterized in a real-world setting. Further, there are limited real-world data on patient adherence to and discontinuation of GLP-1RAs.

Methods: Using the UK Clinical Practice Research Datalink (CPRD) database (2010-2016), we conducted a retrospective cohort study of UK T2D patients ≥ 18 years of age initiating GLP-1RAs to evaluate one-year weight change, as well as GLP-1 RA adherence and discontinuation. Included patients initiated GLP-1RA as monotherapy or as dual therapy with metformin. GLP-1 RA adherence was assessed using the proportion of days covered (PDC) among all GLP-1 RA initiators with two or more prescriptions. Discontinuation was defined as any GLP-1 RA therapy gap >90 days during follow-up.

Results: 589 patients met the study criteria; Female: 56.4%, median age: 54 years, and median BMI: 41.2 kg/m2. The median one-year weight change was -3.1 kg; 72.1% of patients experienced weight loss while the rest of patients reported weight gain. Furthermore, only 32.6% of patients had a weight loss that is typically considered clinically-meaningful (≥5%). In terms of adherence, 64.5% of patients were considered adherent (PDC ≥80%) while 45.2% of patients discontinued GLP-1RA by 1 year.

Conclusion: Less than one-third of patients initiating GLP-1RA achieved ≥5% weight loss. Further, approximately one-third of patients were non-adherent to therapy and nearly half discontinued treatment within a year. Further investigation on the impact of GLP-1 RA adherence and discontinuation on real-world effectiveness is warranted.

Disclosure

T. Weiss: Employee; Self; Merck & Co., Inc. K. Iglay: Employee; Self; Merck & Co., Inc. Stock/Shareholder; Self; Merck & Co., Inc. R.D. Carr: Employee; Self; Merck & Co., Inc. Speaker's Bureau; Spouse/Partner; Eli Lilly and Company, Merck & Co., Inc. A.P. Mishra: None. L. Yang: Employee; Self; Bristol-Myers Squibb Company, Merck & Co., Inc. S. Rajpathak: None.

© 2019 by the American Diabetes Association.
2019
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