Billings Liana K, Handelsman Yehuda, Heile Michael, Schneider Doron, Wyne Kathleen
1 NorthShore University Health System, Skokie, Illinois.
2 Metabolic Institute of America, Tarzana, California.
J Manag Care Spec Pharm. 2018 Sep;24(9-a Suppl):S30-S41. doi: 10.18553/jmcp.2018.24.9-a.s30.
Type 2 diabetes (T2DM) is associated with significant impairment in health-related quality of life (HRQoL). A patient-centered collaborative approach is recommended to optimize clinical outcomes, including HRQoL, in this patient population. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) provide effective glycemic control and have demonstrated beneficial effects on HRQoL and treatment satisfaction. Available once-weekly GLP-1 RAs may offer enhanced convenience compared with daily GLP-1 RAs and include exenatide extended-release (ER), dulaglutide, and semaglutide. This article reviews the impact of once-weekly GLP-1 RAs on HRQoL and treatment satisfaction in patients with T2DM. Compared with oral antihyperglycemic drugs, insulin, and daily GLP-1 RAs, once-weekly GLP-1 RAs offer benefits with regard to HRQoL and treatment satisfaction. These benefits appear to be largely mediated by relative drug effects on glycemic control, weight, and hypoglycemia. While there was not an overall class benefit of once-weekly GLP-1 RAs compared with daily GLP-1 RAs on HRQoL and treatment satisfaction, results suggested that once-weekly GLP-1 RAs may enhance certain elements of treatment satisfaction and increase willingness to continue treatment. In 2 studies comparing once-weekly GLP-1 RAs with each other, semaglutide produced significantly greater improvement in overall treatment satisfaction compared with exenatide ER but not dulaglutide. Once-weekly GLP-1 RAs represent an effective and convenient treatment option that may potentially increase treatment satisfaction and enhance adherence, contributing to improved health outcomes.
This supplement was funded by Novo Nordisk. Billings reports personal fees from Dexcom, Novo Nordisk, and Sanofi. Handelsman reports research grants from Amgen, AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Grifols, Janssen, Lexicon, Merck, Novo Nordisk, Regeneron, and Sanofi; speaker fees from Amarin, Amgen, AstraZeneca, Boehringer Ingelheim-Lilly, Janssen, Merck, Novo Nordisk, Regeneron, and Sanofi; and has served in advisory capacity to Amarin, Amgen, AstraZeneca, Boehringer Ingelheim, Eisai, Intarcia, Janssen, Lilly, Merck, Merck-Pfizer, Novo Nordisk, Regeneron, and Sanofi. Heile reports speaker fees from and has served as advisor to Novo Nordisk. Schneider reports advisory board fees from Intarcia, Lilly, and Novo Nordisk. Wyne has nothing to disclose.
2型糖尿病（T2DM）与健康相关生活质量（HRQoL）的显著受损有关。建议采用以患者为中心的协作方法来优化该患者群体的临床结局，包括HRQoL。胰高血糖素样肽-1受体激动剂（GLP-1 RAs）可有效控制血糖，并已证明对HRQoL和治疗满意度有有益影响。与每日注射的GLP-1 RAs相比，每周注射一次的GLP-1 RAs可能提供更高的便利性，包括艾塞那肽缓释剂（ER）、度拉鲁肽和司美格鲁肽。本文综述了每周注射一次的GLP-1 RAs对T2DM患者HRQoL和治疗满意度的影响。与口服降糖药、胰岛素和每日注射的GLP-1 RAs相比，每周注射一次的GLP-1 RAs在HRQoL和治疗满意度方面具有优势。这些优势似乎很大程度上是由药物对血糖控制、体重和低血糖的相对作用介导的。虽然与每日注射的GLP-1 RAs相比，每周注射一次的GLP-1 RAs在HRQoL和治疗满意度方面没有总体类别的优势，但结果表明，每周注射一次的GLP-1 RAs可能会提高治疗满意度的某些方面，并增加继续治疗的意愿。在两项比较每周注射一次的GLP-1 RAs的研究中，与艾塞那肽ER相比，司美格鲁肽在总体治疗满意度方面有显著更大的改善，但与度拉鲁肽相比则没有。每周注射一次的GLP-1 RAs是一种有效且方便的治疗选择，可能会提高治疗满意度并增强依从性，有助于改善健康结局。
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