Department of Pharmacy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Science, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701, Taiwan.
Cardiovasc Diabetol. 2020 Oct 9;19(1):172. doi: 10.1186/s12933-020-01148-8.
Head-to-head comparison of clinical effectiveness between dulaglutide and liraglutide in Asia is limited. This study was aimed to assess the real-world comparative effectiveness of dulaglutide versus liraglutide.
We conducted a retrospective cohort study by utilizing multi-institutional electronic medical records to identify real-world type 2 diabetes patients treated with dulaglutide or liraglutide during 2016-2018 in Taiwan and followed up until 2019. Effectiveness outcomes were assessed at every 3 months in the 1-year follow-up. Propensity score techniques were applied to enhance between-group comparability. Significant differences in changes of effectiveness outcomes between treatment groups during the follow-up were examined and further analyzed using mixed-model repeated-measures approaches.
A total of 1512 subjects receiving dulaglutide and 1513 subjects receiving liraglutide were identified. At 12 months, significant HbA1c changes from baseline were found in both treatments (dulaglutide: - 1.06%, p < 0.001; liraglutide: - 0.83%, p < 0.001), with a significant between-group difference (- 0.23%, 95% confidence interval - 0.38 to - 0.08%, p < 0.01). Both treatments yielded significant declines in weight, alanine aminotransferase level, and estimated glomerular filtration rate from baseline (dulaglutide: - 1.14 kg, - 3.08 U/L and - 2.08 mL/min/1.73 m, p < 0.01; liraglutide: - 1.64 kg, - 3.65 U/L and - 2.33 mL/min/1.73 m, p < 0.001), whereas only dulaglutide yielded a significant systolic blood pressure reduction (- 2.47 mmHg, p < 0.001). Between-group differences in changes of weight, blood pressure, and liver and renal functions at 12 months were not statistically significant.
In real-world T2D patients, dulaglutide versus liraglutide was associated with better glycemic control and comparable effects on changes of weight, blood pressure, and liver and renal functions.
在亚洲，关于度拉鲁肽和利拉鲁肽的临床疗效的头对头比较有限。本研究旨在评估度拉鲁肽与利拉鲁肽的真实世界比较疗效。
我们通过利用多机构电子病历进行回顾性队列研究，以确定 2016-2018 年在台湾接受度拉鲁肽或利拉鲁肽治疗的 2 型糖尿病患者，并随访至 2019 年。在 1 年的随访中，每 3 个月评估一次疗效结局。采用倾向评分技术提高组间可比性。在随访期间，使用混合模型重复测量方法检查和进一步分析治疗组之间疗效结局变化的显著差异。
共纳入 1512 名接受度拉鲁肽治疗的患者和 1513 名接受利拉鲁肽治疗的患者。在 12 个月时，两组的基线 HbA1c 均有显著变化（度拉鲁肽：-1.06%，p<0.001；利拉鲁肽：-0.83%，p<0.001），两组间存在显著差异（-0.23%，95%置信区间为-0.38 至-0.08%，p<0.01）。两种治疗方法均使体重、丙氨酸氨基转移酶水平和估算肾小球滤过率从基线水平显著下降（度拉鲁肽：-1.14kg，-3.08U/L 和-2.08mL/min/1.73m，p<0.01；利拉鲁肽：-1.64kg，-3.65U/L 和-2.33mL/min/1.73m，p<0.001），而只有度拉鲁肽使收缩压显著降低（-2.47mmHg，p<0.001）。在 12 个月时，两组在体重、血压和肝肾功能变化方面的差异无统计学意义。
在真实世界的 2 型糖尿病患者中，度拉鲁肽与利拉鲁肽相比，血糖控制更好，对体重、血压和肝肾功能的变化影响相当。
