Introduction: Reducing dosing frequency may reduce treatment burden and improve adherence and persistence. We assessed persistence and adherence in patients with T2D initiating once-weekly (OW) or once-daily (OD) injectable glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in US clinical practice.
Methods: Adults (≥ 18 years) with T2D included in the IBM MarketScan Explorys Claims-EMR Data Set for ≥ 180 days pre- and ≥ 365 days post-index, who were GLP-1 RA- and insulin-naïve at first claim for OW or OD injectable GLP-1 RA (index period: 1 Jul 2012-31 Jan 2019; follow-up: index date + 365 days), were propensity score matched 1:1 by age, sex, Charlson Comorbidity Index score, baseline HbA1c and weight (90 days pre-index), and use of sulfonylureas, metformin, DPP-4 inhibitors and SGLT-2 inhibitors (180 days pre-index). Persistence was defined as stay time (patients who had not discontinued [≥ 60 days not covered by medication] within 12 months were censored at 360 days) and assessed using Kaplan-Meier analysis and Cox proportional hazard models. Adherence was defined as proportion of days covered (PDC) ≥ 0.8.
Results: The matched cohorts (n = 784 each) had similar characteristics. Compared with OD GLP-1 RAs, OW were associated with significantly higher persistence (median stay time, 333 days vs. 269 days; hazard ratio 0.80, p < 0.01) and better relative adherence at 6 months (+23%) and 12 months (+35%), irrespective of glycemic improvement and weight change. Mean HbA1c reduction was also greater for OW than for OD treatments at 6 months (-1.1% vs. -0.9%) and 12 months (-0.9% vs. -0.7%). Over 12 months, adherent patients experienced greater mean changes in HbA1c with both OW (-1.1%) and OD (-1.0%) regimens than patients with PDC < 0.8 (-0.6% each).
Conclusions: Our results suggest that, in a real-world setting, OW injectable treatments are associated with better persistence and adherence than OD regimens, irrespective of glycemic or weight control.
A. Liebl: Advisory Panel; Self; AstraZeneca, Becton, Dickinson and Company, Boehringer Ingelheim International GmbH, Eli Lilly and Company, MSD, Novo Nordisk, Roche, Speaker’s Bureau; Self; AstraZeneca, Bayer, Becton, Dickinson and Company, Boehringer Ingelheim International GmbH, Bristol Myers Squibb, Dexcom, Inc., Eli Lilly and Company, Medtronic, MSD, Novo Nordisk, OmniaMed, Roche, Sanofi. R. Arora: Employee; Self; Novo Nordisk. M. Faurby: Employee; Self; Novo Nordisk A/S. J. Da rocha fernandes: Employee; Self; Novo Nordisk A/S, Stock/Shareholder; Self; Novo Nordisk A/S. W. H. Polonsky: Advisory Panel; Self; Intarcia Therapeutics, Inc., Consultant; Self; Abbott Diabetes, ADOCIA, Boehringer Ingelheim Pharmaceuticals, Inc., Dexcom, Inc., Insulet Corporation, Lilly Diabetes, Novo Nordisk, Onduo LLC., Sanofi US.
Novo Nordisk A/S
