Exenatide BID and liraglutide QD treatment patterns among type 2 diabetes patients in Germany

Abstract

Objectives:

This study evaluated patient and prescriber characteristics, treatment patterns, average daily dose (ADD), and glycemic control of patients initiating glucagon-like peptide 1 (GLP-1) receptor agonists in Germany.

Methods:

The LifeLink™ EMR-EU database was searched to identify patients initiating exenatide twice daily (BID) or liraglutide once daily (QD) during the index period (January 1, 2009–April 4, 2010). Eligible patients had ≥180 days pre-index history, ≥90 days post-index follow-up, and a pre-index type 2 diabetes diagnosis. Univariate tests were conducted at α = 0.05.

Results:

Six hundred and ninety-two patients were included (exenatide BID 292, liraglutide QD 400): mean (SD) age 59 (10) years, 59% male. Diabetologists prescribed liraglutide QD to a larger share of patients (65% vs 35% exenatide BID) than non-diabetologists (51% vs 49%). GLP-1 receptor agonist choice was not associated with age (p = 0.282), gender (p = 0.960), number of pre-index glucose-lowering medications (2.0 [0.9], p = 0.159), pre-index HbA1c (8.2 [1.5%], p = 0.231) or Charlson Comorbidity Index score (0.45 [0.78], p = 0.547). Mean (SD) ADD was 16.7 mcg (9.2, label range 10–20 mcg) for exenatide BID and 1.4 mg (0.7, label range 0.6–1.8 mg) for liraglutide QD. Among patients with post-index HbA1c tests, mean unadjusted values did not differ between cohorts. Exenatide BID patients were more likely than liraglutide QD patients to continue pre-index glucose-lowering medications (67.1% vs 60.3%, p = 0.027) or to start concomitant glucose-lowering medications at index (32.2% vs 25.0%, p = 0.013); exenatide BID patients were less likely to augment treatment with another drug post-index (15.8% vs 22.5%, p = 0.027).

Limitations:

Results may not be generalizable. Lab measures for clinical outcomes were available only for a sub-set of patients.

Conclusions:

Results suggested that some differences exist between patients initiating exenatide BID or liraglutide QD, with respect to prescribing physician specialty and pre- and post-index treatment patterns. Both GLP-1 receptor agonists showed comparable post-index HbA1c values in a sub-set of patients.

Keywords::

• Glucagon-like peptide 1 (GLP-1) receptor agonists
• Exenatide
• Liraglutide
• Type-2 diabetes

Transparency

Declaration of funding

This research was funded by Amylin Pharmaceuticals, Inc., San Diego, CA, and by Eli Lilly and Company, Indianapolis, IN.

Declaration of financial/other relationships

L.-A.M. was employed by Eli Lilly and Company, Indianapolis, IN, USA while working on this study. C.B. is employed by IMS Health. IMS Health has ongoing consulting and research relationships with Eli Lilly and Company and Amylin Pharmaceuticals, Inc. A.Z. is employed and receives stock options by Eli Lilly and Company, Indianapolis, IN, USA. M.B. was employed by IMS Health while working on this study. M.R. is employed and receives stock options by Eli Lilly and Company, UK. V.S. is employed by IMS Health. D.B. was employed and received stock options from Eli Lilly and Company, Indianapolis, IN, USA while working on this study.

The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

The authors thank Rebecca McCracken, MSPH, of PharmaNet/i3, part of the inVentiv Health Company, for her contributions to the writing preparation of the manuscript, and Teri Tucker and Casey Brackney for their editorial contributions to the preparation of this manuscript. The authors also thank Jennie Best of Amylin Pharmaceuticals, Inc. for comments on the manuscript.