1873-LB: Comparison of Adherence and Persistence between Oral Semaglutide and Once-Weekly Semaglutide Injection at 12-Month Follow-up in Japanese Real-World Data

This retrospective, observational study aimed to compare 12-month adherence and persistence between oral semaglutide (O-SEMA) and matched Once-Weekly semaglutide Injection (SEMA-I) using real-world administrative claims data from the MDV database. The study included patients with T2D who initiated O-SEMA or SEMA-I between January 2018 and December 2022. SEMA-I initiators were 1:1 propensity-score matched to O-SEMA initiators (9,238 pairs each). Non-adherence was defined as a Proportion of Days Covered (PDC) <0.8. Logistic regression analysis was used with medication adherence (PDC <0.8) as the dependent variable. Persistence rates were compared using Cox regression analysis, with discontinuation of SEMA as the event. Baseline characteristics were balanced, with a mean age of 58 years and 50% females. More O-SEMA initiators were adherent compared to SEMA-I (92.5% vs. 89.8%). The odds ratio for non-adherence significantly increased with SEMA-I compared to SEMA-O (OR: 1.41). More O-SEMA initiators were persistent on therapy compared to SEMA-I (91.7% vs. 82.9%). The hazard ratio for treatment discontinuation, with O-SEMA as the reference, was 1.97 (95% CI 0.81-2.15) for SEMA-I. However, during the first 100 days of treatment, the hazard ratio for SEMA-I compared to O-SEMA was 0.67 (95% CI 0.60-0.76). O-SEMA initiators showed significantly higher adherence and greater persistence on their therapy than SEMA-I initiators in 12-month. On the other hand, it is important to be cautious of the risk of treatment discontinuation in the early stages of O-SEMA administration, as the complexity of management and the method of administration may be influencing factors.