Saunders William B, Nguyen Hiep, Kalsekar Iftekhar
Department of Public Health Sciences, College of Health and Human Services, The University of North Carolina at Charlotte, Charlotte, NC.
AstraZeneca, Fort Washington, PA, USA.
Diabetes Metab Syndr Obes. 2016 Jul 15;9:217-23. doi: 10.2147/DMSO.S103972. eCollection 2016.
The glucagon-like peptide-1 receptor agonists exenatide once weekly (QW) and liraglutide once daily (QD) have demonstrated improvements in glycemic outcomes in patients with type 2 diabetes mellitus in randomized clinical trials. However, little is known about their real-world comparative effectiveness. This retrospective cohort study used the Quintiles Electronic Medical Record database to evaluate the 6-month change in glycated hemoglobin (A1C) for patients initiating exenatide QW or liraglutide QD.
Patients with type 2 diabetes mellitus prescribed exenatide QW (n=664) or liraglutide QD (n=3,283) between February 1, 2012 and May 31, 2013 were identified. Baseline A1C measures were from 75 days before to 15 days after initiating exenatide QW or liraglutide QD, with follow-up measures documented at 6 months (±45 days). Adjusted linear regression models compared the difference in mean A1C change. A priori defined sensitivity analysis was performed in the subgroup of patients with baseline A1C ≥7.0% and no prescription for insulin during the 12-month pre-index period.
For exenatide QW and liraglutide QD, respectively, mean (SD) age of the main study cohort was 58.01 (10.97) and 58.12 (11.05) years, mean (SD) baseline A1C was 8.4% (1.6) and 8.4% (1.6), and 48.2% and 54.2% of patients were women. In adjusted models, change in A1C did not differ between exenatide QW and liraglutide QD during 6 months of follow-up. Results were consistent in the subgroup analyses.
In a real-world setting, A1C similarly improves in patients initiating exenatide QW or liraglutide QD.
在随机临床试验中，每周一次的胰高血糖素样肽-1受体激动剂艾塞那肽和每日一次的利拉鲁肽已证明可改善2型糖尿病患者的血糖结局。然而，关于它们在现实世界中的相对有效性知之甚少。这项回顾性队列研究使用昆泰电子病历数据库评估开始使用每周一次的艾塞那肽或每日一次的利拉鲁肽的患者糖化血红蛋白（A1C）的6个月变化。
确定在2012年2月1日至2013年5月31日期间开具每周一次的艾塞那肽（n = 664）或每日一次的利拉鲁肽（n = 3283）处方的2型糖尿病患者。基线A1C测量值为开始使用每周一次的艾塞那肽或每日一次的利拉鲁肽之前75天至之后15天，随访测量记录在6个月（±45天）时。调整后的线性回归模型比较了平均A1C变化的差异。在基线A1C≥7.0%且在索引前12个月期间未开具胰岛素处方的患者亚组中进行了预先定义的敏感性分析。
对于每周一次的艾塞那肽和每日一次的利拉鲁肽，主要研究队列的平均（标准差）年龄分别为58.01（10.97）岁和58.12（11.05）岁，平均（标准差）基线A1C为8.4%（1.6）和8.4%（1.6），48.2%和54.2%的患者为女性。在调整后的模型中，随访6个月期间，每周一次的艾塞那肽和每日一次的利拉鲁肽之间的A1C变化没有差异。亚组分析结果一致。
在现实世界中，开始使用每周一次的艾塞那肽或每日一次的利拉鲁肽的患者A1C改善情况相似。
