Glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes:real-world evidence from a Mediterranean area. (3rd October 2019)

• Record Type: Journal Article
• Authors: Mata-Cases, Manel; Franch-Nadal, Josep; Ortega, Emilio; Real, Jordi; Gratacòs, Mònica; Vlacho, Bogdan; Mauricio, Dídac
• Is Part Of: Current medical research and opinion. Volume 35:Number 10(2019)
• Page Start: 1735
• Page End: 1744
• Publication Date: 2019-10-03
• Subjects: GLP-1 analogue -- type 2 diabetes mellitus -- primary care -- observational study -- glycemic control; Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1080/03007995.2019.1618806
• Languages: English
• ISSNs: 0300-7995

Abstract

Abstract: Aims: To assess clinical characteristics and factors associated with glycated hemoglobin (HbA1c) reduction in type 2 diabetes (T2DM) patients initiating glucagon-like peptide-1 receptor agonists (GLP-1RAs). Methods : Retrospective cohort study in patients with T2DM who initiated GLP-1RAs between 2007 and 2014 in primary health care centers in Catalonia (Spain). We evaluated changes in HbA1c and body weight at 6–12 months, and factors independently associated with achieving ≥1% HbA1c target reduction. Results: Overall, 4242 patients (47.9% male; mean BMI 37.5 kg/m 2 ) initiated a GLP-1RA. At 6–12 months, the mean HbA1c level decreased from the baseline 8.8% to 7.7% (−1.0%; SD = 1.6). A 1% reduction in HbA1c was observed in 47.2% of patients. Patients lost a mean of 3.6 kg (SD = 6.2). Sixty percent of patients reduced both HbA1c and body weight, and 17% achieved only one of these targets. Independent determinants of a 1% HbA1c reduction were baseline HbA1c, age, diabetes duration and being on insulin treatment. Reduction in weight or HbA1c and the proportion of patients achieving a HbA1c reduction of ≥1% was significantly larger among subjects prescribed liraglutide than exenatide and lixisenatide. Conclusions: In this real-world, retrospective study, the magnitude of HbA1c and body weight reductions after addition of a GLP-1RA were similar to those observed in randomized controlled trials. Approximately 60% of patients attained reductions in both HbA1c and body weight, and there were significant differences among different drugs from this therapeutic group.