The 2018 ADA-EASD consensus report recommends GLP-1 RAs over BI as the first injectable medication in most patients with T2D. The objective of this U.S. retrospective observational study was to compare 1-year real-world glycemic effectiveness among patients with T2D initiating DU vs. BI.
Patients ≥18 years with T2D initiating DU or BI between Nov’14 - Apr’17 (index date=earliest fill date), and no claim for any antidiabetic injectable in 6 months pre-index period (baseline), continuous enrollment and ≥1 HbA1c result 6 months pre-index and 1-year post-index were identified from a U.S. claims database. DU users were propensity-matched 1:1 to BI users.
The pre-matching mean baseline HbA1c for DU cohort (n=1,103) was 8.4% vs. 9.9% for BI cohort (n=3,193). Matched cohorts (903 pairs) were balanced in baseline characteristics with mean HbA1c: ∼8.6%, mean age: 54 years, SGLT2 inhibitor use: 24% and DPP-4 inhibitor use: ∼38%. At 1-year post-index, 11% of DU cohort used BI and 10% of BI cohort used GLP-1 RAs; DU patients used less rapid-acting insulin (2% vs. 16%) and DPP-4 inhibitors (24% vs. 39%) and more SGLT2 inhibitors (34% vs. 23%) vs. BI patients. The key glycemic effectiveness results are included in the Table.
In this real-world study, patients with T2D initiating DU demonstrated significantly greater and clinically meaningful HbA1c reduction compared to those initiating BI.
R. Mody: Employee; Self; Eli Lilly and Company. Q. Huang: None. M. Yu: Employee; Self; Eli Lilly and Company. Employee; Spouse/Partner; Lifelabs. Stock/Shareholder; Self; Eli Lilly and Company. X. Zhang: None. L. Wang: Employee; Self; HealthCore. Employee; Spouse/Partner; Janssen Pharmaceuticals, Inc. M. Grabner: None. H. Patel: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company.
Eli Lilly and Company