Glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes:real-world evidence from a Mediterranean area
Por:
Mata-Cases, M, Franch-Nadal, J, Ortega, E, Rear, J, Gratacos, M, Vlacho, B, Mauricio, D
Publicada:
3 oct 2019
Ahead of Print:
1 jun 2019
Resumen:
Aims: To assess clinical characteristics and factors associated with glycated hemoglobin (HbA1c) reduction in type 2 diabetes (T2DM) patients initiating glucagon-like peptide-1 receptor agonists (GLP-1RAs). Methods: Retrospective cohort study in patients with T2DM who initiated GLP-1RAs between 2007 and 2014 in primary health care centers in Catalonia (Spain). We evaluated changes in HbA1c and body weight at 6-12 months, and factors independently associated with achieving >= 1% HbA1c target reduction. Results: Overall, 4242 patients (47.9% male; mean BMI 37.5 kg/m(2)) initiated a GLP-1RA. At 6-12 months, the mean HbA1c level decreased from the baseline 8.8% to 7.7% (-1.0%; SD = 1.6). A 1% reduction in HbA1c was observed in 47.2% of patients. Patients lost a mean of 3.6 kg (SD = 6.2). Sixty percent of patients reduced both HbA1c and body weight, and 17% achieved only one of these targets. Independent determinants of a 1% HbA1c reduction were baseline HbA1c, age, diabetes duration and being on insulin treatment. Reduction in weight or HbA1c and the proportion of patients achieving a HbA1c reduction of >= 1% was significantly larger among subjects prescribed liraglutide than exenatide and lixisenatide. Conclusions: In this real-world, retrospective study, the magnitude of HbA1c and body weight reductions after addition of a GLP-1RA were similar to those observed in randomized controlled trials. Approximately 60% of patients attained reductions in both HbA1c and body weight, and there were significant differences among different drugs from this therapeutic group.
Filiaciones:
Mata-Cases, M:
Fundacio Inst Univ Recerca Atencio Primaria Salut, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona, Spain
ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid, Spain
Inst Catala Salut, Primary Hlth Care Ctr Raval Sud, Gerencia Ambit Atencio Primaria Barcelona Ciutat, St Adria De Besos, Spain
Franch-Nadal, J:
Fundacio Inst Univ Recerca Atencio Primaria Salut, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona, Spain
ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid, Spain
Inst Catala Salut, Primary Hlth Care Ctr Raval Sud, Gerencia Ambit Atencio Primaria, St Adria De Besos, Spain
Ortega, E:
Hosp Clin Barcelona, Inst Invest Biomed August Pi & Suner, Dept Endocrinol & Nutr, Barcelona, Spain
ISCIII, CIBER Physiopathol Obes & Nutr CIBEROBN, Madrid, Spain
Rear, J:
Fundacio Inst Univ Recerca Atencio Primaria Salut, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona, Spain
ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid, Spain
Gratacos, M:
Fundacio Inst Univ Recerca Atencio Primaria Salut, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona, Spain
Vlacho, B:
Fundacio Inst Univ Recerca Atencio Primaria Salut, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona, Spain
Mauricio, D:
Fundacio Inst Univ Recerca Atencio Primaria Salut, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona, Spain
ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid, Spain
Autonomous Univ Barcelona, Hosp Univ Santa Creu & St Pau, Dept Endocrinol & Nutr, Barcelona, Spain
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