Glucagon-Like Peptide-1 Receptor Agonist Utilization in Type 2 Diabetes in Japan: A Retrospective Database Analysis (JDDM 57)

Dec 10, 2020Diabetes therapy : research, treatment and education of diabetes and related disorders

Use of Glucagon-Like Peptide-1 Receptor Agonists in Japanese People with Type 2 Diabetes: A Retrospective Database Study

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Abstract

A total of 932 patients with type 2 diabetes initiated therapy, primarily with dulaglutide (65.7%).

Mean age of patients was 63.8 years, with 56.0% being male.
Hemoglobin A1c levels decreased from 8.3% to 7.8% over 6 months after starting therapy, with those achieving HbA1c < 7.0% rising from 14.4% to 22.9%.
Significant reductions in mean body weight, body mass index, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and adjusted urinary albumin were observed over 6 months.
Antidiabetic medication use decreased following GLP-1 RA initiation, while non-antidiabetic medication prescribing remained stable.
Persistence rates for index GLP-1 RA were 80.5%, 66.2%, and 51.6% at 6, 12, and 18 months, respectively.
Dulaglutide showed higher persistence rates compared to liraglutide at each time point measured.

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INTRODUCTION: There are limited real-world data on the prescribing of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for patients with type 2 diabetes mellitus (T2DM).

METHODS: This was a retrospective analysis of the CoDiC® database of the Japan Diabetes Clinical Data Management Study Group (JDDM). Demographic and clinical characteristics, concomitant treatment patterns, and treatment persistence or modification in patients with T2DM initiating GLP-1 RA therapy were evaluated.

RESULTS: The analysis included 932 eligible patients with T2DM who had their first GLP-1 RA prescription (index date) between September 2016 and July 2018. Mean age was 63.8 years and 56.0% were male. Most patients had an index GLP-1 RA of dulaglutide (65.7%) or liraglutide (29.1%). Common comorbidities were obesity (58.7%), hypertension (54.7%), dyslipidemia (52.0%), retinopathy (11.3%), and nephropathy (10.2%). Mean hemoglobin A1c (HbA1c) levels decreased from 8.3 to 7.8% over 6 months after GLP-1 RA initiation, and the proportion of patients achieving HbA1c < 7.0% increased from 14.4% at index date to 22.9% at 6 months. Reductions occurred in mean body weight, body mass index, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and adjusted urinary albumin over 6 months. Antidiabetic medication use decreased after GLP-1 RA initiation, whereas non-antidiabetic medication prescribing showed little change. Index GLP-1 RA persistence rates were 80.5%, 66.2%, and 51.6% at 6, 12, and 18 months post-index, respectively, with a median persistence until discontinuation or switch of 600 days. Persistence rates at 6, 12, and 18 months post-index, respectively, were 81.9%, 70.7%, and 65.4% for dulaglutide and 79.7%, 60.0%, and 30.4% for liraglutide.

CONCLUSION: The study shows real-world benefits of GLP-1 RA therapy for T2DM, including improvements in HbA1c, body weight, and blood lipid profile, and supports the high rates of long-term persistence previously reported with dulaglutide, the GLP-1 RA most commonly prescribed for T2DM in Japanese clinical practice.

Key numbers

0.5%

HbA1c Reduction

Mean HbA1c levels decreased from 8.3% to 7.8% after 6 months.

1.3 kg

Weight Loss

Mean body weight decreased during the 6-month treatment period.

80.5%

Treatment Persistence

Persistence rate at 6 months post-index for therapy.

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Glucagon-Like Peptide-1 Receptor Agonist Utilization in Type 2 Diabetes in Japan: A Retrospective Database Analysis (JDDM 57)

Abstract

Key numbers

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