Glycemic Control and Weight Outcomes for Exenatide Once Weekly Versus Liraglutide in Patients with Type 2 Diabetes: A 1-Year Retrospective Cohort Analysis.

PURPOSE

Data comparing real-world effectiveness of the glucagon-like peptide-1 receptor agonists (GLP-1RAs) exenatide once weekly (QW) and liraglutide in the treatment of type 2 diabetes (T2D) are limited. Furthermore, there is limited information on exenatide QW or liraglutide response by glycemic control and insulin use status. This study identifies 1-year glycosylated hemoglobin (HbA) and weight outcomes with exenatide QW and liraglutide in the real-world setting overall and in insulin-naive patients with uncontrolled T2D.

METHODS

This retrospective cohort study using national electronic medical record data compared 1-year HbA and weight outcomes in patients with T2D prescribed exenatide QW or liraglutide. Included patients were adults (≥18 years old) with T2D who were GLP-1RA naive when newly prescribed exenatide QW or liraglutide between January 1, 2012, and March 31, 2013 (index date). Outcomes were reported descriptively overall and in subsets of insulin-naive patients with baseline HbA ≥7.0% or ≥9.0%. Multivariable linear regression analyses were performed to estimate adjusted change in HbA and weight.

FINDINGS

The study included 808 exenatide QW and 4333 liraglutide patients. Mean (SD) age was 57 (11) years in both groups. Mean baseline HbA was 8.3% (1.5%) in exenatide QW patients and 8.4% (1.6%) in liraglutide patients (P = 0.66); 16 (2%) of the exenatide QW and 1099 (25.4%) of the liraglutide patients were newly prescribed insulin on the index date (P < 0.001). Adjusted mean HbA change at 1 year was -0.37% (95% CI, -0.53% to -0.21%) for exenatide QW and -0.37% (95% CI, -0.55% to -0.18%) for liraglutide. Adjusted HbA reduction was more pronounced in insulin-naive patients with baseline HbA ≥7.0% (-0.71% and -0.80% for the exenatide QW and liraglutide patients, respectively, P > 0.05) and ≥9.0% (-1.73% and -1.57% for exenatide QW and liraglutide patients, respectively, P > 0.05). Mean (adjusted) weight loss was -2.22 kg (95% CI, -3.06 to -1.37 kg) with exenatide QW and -2.21 kg (95% CI, -3.18 to -1.23 kg) with liraglutide.

IMPLICATIONS

Exenatide QW and liraglutide lead to similar HbA and weight reductions at 1 year in the real-world setting. Greater HbA reductions occurred in insulin-naive patients with baseline HbA ≥7.0%. Both agents are appropriate options for patients needing antidiabetes therapy to lower HbA while promoting weight loss.