Novo Nordisk, Inc., 800 Scudders Mill Rd, Plainsboro, NJ, USA.
Novo Nordisk A/S, Vandtårnsvej 114, DK-2800 Søborg, Denmark.
Diabetes Res Clin Pract. 2018 Sep;143:348-356. doi: 10.1016/j.diabres.2018.07.017. Epub 2018 Aug 23.
Evaluate real-world data on persistence with anti-obesity medications (AOMs) and explore associated patient factors.
Truven Health MarketScan® data were analyzed to evaluate utilization of AOMs approved for long-term use between 4/2015 and 3/2016. Kaplan-Meier survival analyses were used to evaluate treatment persistence. A multivariate analysis was performed to identify associations between persistence and relevant factors.
In total, 26,522 adult patients were identified as newly prescribed naltrexone/bupropion (44.0%, mean age 47.1, 80.5% female), lorcaserin (24.8%, 48.5, 79.3%), phentermine/topiramate extended release (15.8%, 46.7, 82.2%) or liraglutide 3.0 mg (15.4%, 46.9, 72.4%). At 6 months, 41.8% of patients were still on liraglutide 3.0 mg, compared to 15.9% lorcaserin (p < 0.001), 18.1% naltrexone/bupropion (p < 0.001), and 27.3% phentermine/topiramate (p < 0.001). After adjusting for baseline factors, patients on liraglutide 3.0 mg had significantly lower risk of discontinuation compared to those on lorcaserin (HR = 0.46, p < 0.0001), naltrexone/bupropion (HR = 0.48, p < 0.0001), and phentermine/topiramate (HR = 0.64, p < 0.0001) over the course of follow-up (mean follow-up duration, 342-427 days). Older age, male gender, having hyperlipidemia, and no prior phentermine use were associated with higher persistence. Over 95% of study patients had commercial insurance.
In a real-world setting, patients on liraglutide 3.0 mg had the highest persistence rate of the four AOMs studied.
评估抗肥胖药物（AOM）实际应用中的持续使用情况，并探索相关的患者因素。
分析 Truven Health MarketScan® 数据，以评估在 2015 年 4 月至 2016 年 3 月期间批准用于长期使用的 AOM 的使用情况。采用 Kaplan-Meier 生存分析评估治疗的持续性。进行多变量分析以确定持续性与相关因素之间的关联。
共确定了 26522 名新处方纳曲酮/安非他酮（44.0%，平均年龄 47.1，80.5%为女性）、lorcaserin（24.8%，48.5，79.3%）、phentermine/topiramate 延长释放剂（15.8%，46.7，82.2%）或 liraglutide 3.0mg（15.4%，46.9，72.4%）的成年患者。6 个月时，41.8%的患者仍在使用 liraglutide 3.0mg，而 lorcaserin 为 15.9%（p<0.001），纳曲酮/安非他酮为 18.1%（p<0.001），phentermine/topiramate 为 27.3%（p<0.001）。调整基线因素后，与 lorcaserin 相比，liraglutide 3.0mg 治疗组患者停药风险显著降低（HR=0.46，p<0.0001），与 naltrexone/bupropion（HR=0.48，p<0.0001）和 phentermine/topiramate（HR=0.64，p<0.0001）相比，在随访过程中（平均随访时间 342-427 天）。年龄较大、男性、患有高脂血症和无先前 phentermine 使用史与更高的持久性相关。超过 95%的研究患者拥有商业保险。
在真实环境中，与其他四种 AOM 相比，liraglutide 3.0mg 的患者持续使用率最高。
