Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia
Por:
Franch-Nadal, J, Mata-Cases, M, Ortega, E, Real, J, Gratacos, M, Vlacho, B, Valles, JA, Mauricio, D
Publicada:
1 sep 2019
Resumen:
To assess the clinical characteristics, the prescription pattern of GLP-1 receptor agonists (GLP-1RA) users, and HbA1c and weight change, we retrospectively assessed patients with type 2 diabetes by initiating GLP-1RA as an add-on to the standard of care in Catalonia. The mean change from the baseline in glycated hemoglobin (HbA1c) and weight at 6 and 12 months of therapy was calculated, and we assessed the predictors of the HbA1c reduction of >= 1% and/or the weight reduction of >= 3% as recommended by the Catalan Health Service. In 2854 patients who initiated a GLP-1RA during 2014 and 2015, the overall mean HbA1c values were reduced from the baseline by -0.84% (SD = 1.66) (-9.2 mmol/mol) and lost on average 2.73 kg (SD = 6.2). About 44% percent of patients decreased their HbA1c by >= 1%; 44% decreased their weight by >= 3%; and only 22% met both of them together. The odds of achieving a reduction of >= 1% in initial HbA1c were two-fold higher for patients with higher baseline levels, and the likelihood of a reduction of >= 3% in the initial weight was associated with a higher BMI at the baseline, but they were independent of each other. The composite outcome (target 1% HbA1c reduction and 3% weight loss) to evaluate both the GLP-1RA clinical benefit and treatment withdrawal should be judged from a patient-centered approach.
Filiaciones:
Franch-Nadal, J:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08007, Spain
Inst Salud Carlos III, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid 28029, Spain
Inst Catala Salut, Primary Hlth Care Ctr Raval Sud Gerencia Atencio, Barcelona 08028, Spain
Mata-Cases, M:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08007, Spain
Inst Salud Carlos III, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid 28029, Spain
Inst Catala Salut, Primary Hlth Care Ctr La Mina Gerencia Ambit Aten, Barcelona 08930, Spain
Ortega, E:
Hosp Clin Barcelona, Inst Invest Biomed August Pi & Suner, Dept Endocrinol & Nutr, Barcelona 08036, Spain
Inst Salud Carlos III, CIBER Physiopathol Obes & Nutr CIBEROBN, Madrid 28029, Spain
Real, J:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08007, Spain
Inst Salud Carlos III, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid 28029, Spain
Gratacos, M:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08007, Spain
Vlacho, B:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08007, Spain
Valles, JA:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08007, Spain
Inst Catala Salut, Gerencia Atencio Primaria, Drug Area, Barcelona 08028, Spain
Mauricio, D:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona 08007, Spain
Inst Salud Carlos III, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid 28029, Spain
Autonomous Univ Barcelona, Dept Endocrinol & Nutr, Hosp Santa Creu & St Pau, Barcelona 08041, Spain
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