Medication adherence to injectable glucagon‐like peptide‐1 (GLP‐1) receptor agonists dosed once weekly vs once daily in patients with type 2 diabetes: A meta‐analysis

Feb 2, 2021International journal of clinical practice

Medication adherence to weekly versus daily injectable GLP-1 treatments in type 2 diabetes patients: A meta-analysis

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Abstract

Once weekly dosing of injectable GLP-1 receptor agonists (GLP-1RAs) is associated with a 11% lower risk of non-adherence compared to once daily dosing.

A meta-analysis included 7 studies with a total of 75,159 patients with type 2 diabetes.
Non-adherence was defined as a proportion of days covered (PDC) of less than 80%.
Follow-up periods for the studies ranged from 6 to 12 months.
The injectable GLP-1RAs evaluated included dulaglutide, albiglutide, and exenatide for once weekly, and liraglutide for once daily dosing.
The findings indicate that dosing frequency may impact medication adherence significantly.

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BACKGROUND: Suboptimal medication adherence has been associated with increased resource utilisation and mortality among patients with type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are becoming increasingly important in the treatment of T2D. However, medications in this class differ considerably in their dosing frequency, which may impact adherence. We sought to perform a meta-analysis to compare adherence to injectable GLP-1RAs dosed once weekly vs once daily in patients with T2D.

METHODS: Medline and Scopus were searched from 1/2005 to 7/2020 using keywords and MeSH terms pertaining to adherence and GLP-1RAs. Studies of adults with T2D were included if they compared adherence (as measured by proportion of days covered [PDC]) to injectable GLP-1RAs dosed once weekly vs once daily. A meta-analysis of non-overlapping studies was performed to evaluate the primary outcome of non-adherence, defined as the proportion of patients with a PDC < 80.

RESULTS: A total of 7 studies evaluating 75 159 patients (range: 2886-30 097) with T2D were included. The follow-up periods of included studies ranged from 6 to 12 months. Injectable GLP-1RAs dosed once weekly were either dulaglutide, albiglutide or exenatide extended release; while liraglutide was the injectable once daily agent evaluated in all included studies. Upon meta-analysis, once weekly GLP-1RA dosing was associated with an 11% lower risk of non-adherence compared to once daily dosing (risk ratio = 0.89; 95% confidence interval = 0.83-0.95; I = 89%). 2

CONCLUSION: Once weekly dosing of injectable GLP-1RAs was associated with better adherence vs once daily dosing among patients with T2D. These findings coupled with the known detrimental consequences of non-adherence suggest that dosing frequency is an important factor to consider when selecting a GLP-1RA.

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Medication adherence to injectable glucagon‐like peptide‐1 (GLP‐1) receptor agonists dosed once weekly vs once daily in patients with type 2 diabetes: A meta‐analysis

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