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Treatment Patterns in Patients with Type 2 Diabetes Mellitus Treated with GLP-1 Receptor Agonists: Higher Adherence and Persistence with Dulaglutide Compared to Exenatide QW and Liraglutide.

Treatment Patterns in Patients with Type 2 Diabetes Mellitus Treated with GLP-1 Receptor Agonists: Higher Adherence and Persistence with Dulaglutide Compared to Exenatide QW and Liraglutide.
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Alatorre C, Fernández Landó L, Yu M, Brown K, Montejano L, Juneau P, Mody R, Swindle R,


Alatorre C, Fernández Landó L, Yu M, Brown K, Montejano L, Juneau P, Mody R, Swindle R, (click to view)

Alatorre C, Fernández Landó L, Yu M, Brown K, Montejano L, Juneau P, Mody R, Swindle R,

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Diabetes, obesity & metabolism 2017 02 09() doi 10.1111/dom.12902
Abstract
AIMS
The overall study aims were to compare adherence (proportion of days covered [PDC]), persistence, and treatment patterns among patients with type 2 diabetes mellitus (T2DM) newly initiating Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs). More specifically, the main objectives were to compare dulaglutide vs. exenatide once weekly (QW) and dulaglutide vs. liraglutide.

MATERIALS AND METHODS
T2DM patients newly initiating dulaglutide, albiglutide, exenatide QW, exenatide twice-daily (BID), and liraglutide between November 2014 and April 2015, were hierarchically selected from Truven Health’s MarketScan(®) Research Databases. Propensity score matching was used to account for selection bias. Adherence and persistence to the index GLP-1 RA, and switching and augmentation patterns were assessed during the 6-month post-index period.

RESULTS
Mean adherence for the matched cohorts was significantly higher for dulaglutide compared to exenatide QW (0.72 vs. 0.61; p < 0.0001) and liraglutide (0.71 vs. 0.67; p < 0.0001). Percentage of patients achieving PDC ≥0.80 was significantly higher for dulaglutide compared to exenatide QW (54.2% vs. 37.9%; p < 0.0001) and liraglutide (53.5% vs. 44.3%; p < 0.0001). The mean [SD] days on treatment for all matched patients was significantly higher for dulaglutide compared to exenatide QW (148.4 [55.4] vs. 123.6 [61.6], p < 0.0001) and liraglutide (146.0 [56.9] vs. 137.4 [60.1], p < 0.0001) patients. A significantly lower proportion of dulaglutide patients discontinued treatment compared to exenatide QW (26.2% vs. 48.4%; p < 0.0001) and liraglutide (28.0% vs. 35.6%; p < 0.0001). CONCLUSIONS
Dulaglutide initiators had significantly higher adherence, were more persistent, and had lower discontinuation compared to exenatide QW or liraglutide during the 6-month follow up period.

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