Department of Pharmacy, Faculty of Pharmacy, Musashino University, Tokyo, Japan.
Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan.
J Diabetes Investig. 2024 Nov;15(11):1578-1584. doi: 10.1111/jdi.14265. Epub 2024 Sep 7.
Adherence and treatment continuation rates of the glucagon-like peptide-1 receptor agonist (GLP-1RA) semaglutide for both oral (O-SEMA) and subcutaneous injection (SEMA-SC) remain unknown in real-world clinical practice. This retrospective observational study compared the 12 month adherence and treatment discontinuation of O-SEMA and once-weekly SEMA-SC in patients with type 2 diabetes using a real-world claims database. SEMA-SC initiators were 1:1 propensity score-matched to O-SEMA initiators. Non-adherence was defined as <0.8 of the proportion of days covered. SEMA-SC had a significantly higher odds ratio (OR) for non-adherence than O-SEMA (OR: 1.39). The hazard ratio for treatment discontinuation, using O-SEMA as the reference, was 1.45 for SEMA-SC, although the discontinuation rate of O-SEMA was higher during the early stage. O-SEMA initiators showed significantly higher adherence and greater persistence in therapy than SEMA-SC initiators at 12 months, which could lead to earlier initiation of GLP-1RA treatment.
在真实临床实践中，尚不清楚胰高血糖素样肽-1 受体激动剂（GLP-1RA）司美格鲁肽的口服（O-SEMA）和皮下注射（SEMA-SC）的依从性和治疗持续率。本回顾性观察性研究使用真实世界的理赔数据库比较了 2 型糖尿病患者中 12 个月时 O-SEMA 和每周一次 SEMA-SC 的依从性和治疗停药情况。SEMA-SC 起始者与 O-SEMA 起始者按 1:1 的倾向评分匹配。依从性定义为<0.8 的覆盖天数比例。与 O-SEMA 相比，SEMA-SC 的不依从性比值比（OR）显著更高（OR：1.39）。以 O-SEMA 为参照，SEMA-SC 的治疗停药风险比（HR）为 1.45，尽管 O-SEMA 的停药率在早期较高。在 12 个月时，O-SEMA 起始者的依从性和治疗持久性显著高于 SEMA-SC 起始者，这可能导致更早开始 GLP-1RA 治疗。
