Divino Victoria, Boye Kristina S, Lebrec Jeremie, DeKoven Mitch, Norrbacka Kirsi
IQVIA, Falls Church, VA, USA.
Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.
Diabetes Ther. 2019 Jun;10(3):1067-1088. doi: 10.1007/s13300-019-0615-5. Epub 2019 Apr 26.
The glucagon-like peptide-1 receptor agonist (GLP-1 RA) class is evolving and expanding. This retrospective database study evaluated recent real-world treatment and dosing patterns of patients with type 2 diabetes (T2D) initiating GLP-1 RAs in Belgium (BE), France (FR), Germany (DE), Italy (IT), the Netherlands (NL), and Canada (CA).
Adult T2D patients initiating GLP-1 RA therapy (dulaglutide [DULA], exenatide twice daily [exBID], exenatide once weekly [exQW], liraglutide [LIRA], or lixisenatide [LIXI]) from 2015 to 2016 were identified using the IQVIA (IQVIA, Durham, NC, and Danbury, CT, USA) Real-World Data Adjudicated Pharmacy Claims. The therapy initiation date was termed the 'index date.' Eligible patients had ≥ 180 days pre-index and ≥ 360 days post-index. Persistence (until discontinuation or switch) was evaluated over the variable follow-up using Kaplan-Meier (KM) survival analysis. Average daily dose (ADD) was calculated until discontinuation or switch.
A total of 34,649 DULA, 3616 exBID, 11,138 exQW, 48,317 LIRA, and 2,204 LIXI patients were included in the analysis (34.9-63.2% female; median age range 53-62 years; median follow-up 16-30 months). Proportion persistent at 1-year post-index was 36.8-67.2% for DULA, 5.9-44.4% for exBID, 24.7-44.2% for exQW, 22.2-57.5% for LIRA, and 15.5-40.0% for LIXI. Median time persistent (days) was 245-381 for DULA, 62-243 for exBID, 121-319 for exQW, 103-507 for LIRA, and 99-203 for LIXI. Mean ADD was 13.21-20.43 µg for exBID, 1.44-1.68 mg for LIRA, and 19.88-20.54 µg for LIXI. Mean average weekly dose (AWD) ranged from 2.03 to 2.14 mg for exQW. Mean AWD for DULA was 1.25 mg in Canada and ranged from 1.43 to 1.53 mg in the other countries.
Across six countries, persistence was highest among DULA patients and generally lowest among exBID patients. ADD/AWD for all GLP-1 RAs was in line with the recommended label. Longer-term data would be useful to obtain a better understanding of GLP-1 RA treatment patterns over time.
Eli Lilly and Company, Indianapolis, IN, USA.
胰高血糖素样肽-1受体激动剂（GLP-1 RA）类别正在不断发展和扩大。这项回顾性数据库研究评估了比利时（BE）、法国（FR）、德国（DE）、意大利（IT）、荷兰（NL）和加拿大（CA）开始使用GLP-1 RA的2型糖尿病（T2D）患者的近期真实世界治疗和给药模式。
使用IQVIA（IQVIA，美国北卡罗来纳州达勒姆和康涅狄格州丹伯里）的真实世界数据判定药房索赔，识别出2015年至2016年开始接受GLP-1 RA治疗（度拉糖肽[DULA]、每日两次艾塞那肽[exBID]、每周一次艾塞那肽[exQW]、利拉鲁肽[LIRA]或利司那肽[LIXI]）的成年T2D患者。治疗开始日期被称为“索引日期”。符合条件的患者在索引日期前有≥180天，索引日期后有≥360天。使用Kaplan-Meier（KM）生存分析在可变随访期间评估持续时间（直至停药或换药）。计算直至停药或换药的平均每日剂量（ADD）。
共有34649例DULA、3616例exBID、11138例exQW、48317例LIRA和2204例LIXI患者纳入分析（女性占34.9 - 63.2%；年龄中位数范围53 - 62岁；中位随访时间16 - 30个月）。索引日期后1年的持续比例，DULA为36.8 - 67.2%，exBID为5.9 - 44.4%，exQW为24.7 - 44.2%，LIRA为22.2 - 57.5%，LIXI为15.5 - 40.0%。持续时间中位数（天），DULA为245 - 381，exBID为62 - 243，exQW为121 - 319，LIRA为103 - 507，LIXI为99 - 203。exBID的平均ADD为13.21 - 20.43μg，LIRA为1.44 - 至1.68mg，LIXI为19.88 - 20.54μg。exQW的平均每周剂量（AWD）范围为2.03至2.14mg。DULA在加拿大的平均AWD为1.2mg，在其他国家为1.43至1.53mg。
在六个国家中，DULA患者的持续率最高，exBID患者通常最低。所有GLP-1 RA的ADD/AWD与推荐标签一致。长期数据将有助于更好地了解GLP-1 RA随时间的治疗模式。
美国印第安纳州印第安纳波利斯礼来公司。
