First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
Sci Rep. 2022 Jan 7;12(1):154. doi: 10.1038/s41598-021-04149-z.
Real-world data comparing the effectiveness of various glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in type 2 diabetes mellitus (T2DM) are limited. We investigated the clinical effectiveness of liraglutide and dulaglutide in Japanese T2DM in a real-world setting. This retrospective study included 179 patients with T2DM who were treated with GLP-1 RA for at least 12 months (liraglutide, n = 97; dulaglutide, n = 82). We used stabilized propensity score-based inverse probability of treatment weighting (IPTW) to reduce selection bias and confounding by observed covariates. Changes in glycated hemoglobin (HbA1c) at the end of the 12-month treatment were evaluated. After adjustment by stabilized propensity score-based IPTW, no significant differences were observed in patient characteristics between the liraglutide and dulaglutide groups. HbA1c was significantly lower at 12 months in both groups (liraglutide, 8.9 to 7.4%; dulaglutide, 8.7 to 7.5%). Multivariate linear regression analysis showed no differences in the extent of changes in HbA1c at 12 months between the two agents. High baseline HbA1c, the addition of GLP-1 RA treatment modality, and in-hospital initiation of GLP-1 RA treatment were identified as significant contributing factors to HbA1c reduction. The effects of liraglutide and dulaglutide on lowering HbA1c levels at 12 months were comparable in a real-world setting.
在真实世界中,比较各种胰高血糖素样肽 1 受体激动剂(GLP-1 RAs)在 2 型糖尿病(T2DM)中的疗效的数据有限。我们在真实环境中研究了利拉鲁肽和度拉鲁肽在日本 T2DM 患者中的临床疗效。这项回顾性研究纳入了 179 名至少接受 GLP-1 RA 治疗 12 个月的 T2DM 患者(利拉鲁肽组,n=97;度拉鲁肽组,n=82)。我们使用稳定倾向评分逆概率治疗加权(IPTW)来减少观察性协变量引起的选择偏差和混杂。评估治疗 12 个月后糖化血红蛋白(HbA1c)的变化。经稳定倾向评分逆概率治疗加权调整后,两组患者的特征无显著差异。两组患者的 HbA1c 在 12 个月时均显著降低(利拉鲁肽组从 8.9%降至 7.4%;度拉鲁肽组从 8.7%降至 7.5%)。多变量线性回归分析显示,两种药物在 12 个月时 HbA1c 变化程度无差异。基线 HbA1c 较高、GLP-1 RA 治疗方式的增加以及住院时开始 GLP-1 RA 治疗被确定为 HbA1c 降低的重要影响因素。在真实环境中,利拉鲁肽和度拉鲁肽降低 HbA1c 水平的效果相当。