Clinical characteristics, treatment patterns, and persistence in individuals with type 2 diabetes initiating a glucagon‐like peptide‐1 receptor agonist: A retrospective analysis of the Diabetes Prospective Follow‐Up Registry

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2023-07, Vol.25 (7), p.1813-1822
• Main Authors: Jung, Heike, Tittel, Sascha R., Schloot, Nanette C., Heitmann, Elke, Otto, Thorsten, Lebrec, Jeremie, Pavel, Marianne, Lanzinger, Stefanie
• Format: Article
• Language: English
• Subjects: Adult; Aged; Agonists; Antidiabetics; database research; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Female; Follow-Up Studies; GLP-1 receptor agonists; GLP‐1 analogue; Glucagon; Glucagon-Like Peptide 1; Glucagon-Like Peptide-1 Receptor - agonists; Glycated Hemoglobin; Hemoglobin; Humans; Hypoglycemic Agents; incretin therapy; Insulin; Insulin, Regular, Human; Male; Middle Aged; Peptides; Prospective Studies; Retrospective Studies; type 2 diabetes
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.15038

Aims To describe clinical characteristics, treatment patterns and glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA) persistence in individuals with type 2 diabetes (T2D) initiating their first GLP‐1 RA. Materials and Methods A real‐world analysis of adults with T2D initiating GLP‐1 RA therapy between 2007 and June 2020 from the multicentre Diabetes Prospective Follow‐Up (DPV) Registry, stratified by antidiabetes therapy at the time of GLP‐1 RA initiation: oral antidiabetic drugs (OAD), insulin ± OAD or lifestyle modification (LM). GLP‐1 RA treatment persistence in individuals with ≥12 months follow‐up was determined by Kaplan‐Meier analysis. Results Overall, 15 111 individuals with T2D initiating GLP‐1 RA therapy (55% men) were identified; median [interquartile range (IQR)] age [58.7 (50.6‐66.7) years], diabetes duration [8.5 (3.6‐14.7) years], glycated haemoglobin [HbA1c; 8.2 (7.1‐9.8)%]. Median (95% confidence interval) GLP‐1 RA persistence in eligible individuals (n = 5189) was 11 (10‐12) months; OAD 12 (11‐14) months (n = 2453); insulin ± OAD 11 (9‐12) months (n = 2204); and LM 7 (5‐9) months (n = 532). Median treatment persistence tended to increase from 2007‐2012 to 2017‐2020. Median (IQR) HbA1c decreased from baseline [8.2 (7.1‐9.8)%] to discontinuation [7.5 (6.6‐8.7)%], with a greater decrease observed in individuals with persistence >12 months versus ≤12 months. Individuals who discontinued GLP‐1 RA therapy predominantly switched to insulin (if not already using) or dipeptidyl peptidase‐4 inhibitors. Conclusion Real‐world registry data revealed improved outcomes with longer median GLP‐1 RA persistence; ~50% of patients overall achieved HbA1c