Real-world glycemic outcomes in patients with type 2 diabetes initiating exenatide once weekly and liraglutide once daily: a retrospective cohort study

Figures & data

Table 1 Sample attrition

Criteria	6 months of follow-up
	Exenatide QW		Liraglutide QD
	N	%	N	%
1. Initial prescription as of 2/1/2012	4,404	100.00	25,341	100.00
2. Age 18+ on the index date	4,403	99.98	25,325	99.94
3. Diabetes diagnosis or drug treatment	4,263	96.80	23,549	92.93
4. Clinical activity in the past year	3,624	82.29	20,178	79.63
5. No prescription for any GLP-1 in the 12 months prior to the index date	2,329	52.88	13,289	52.44
6. No A1C reading at baseline and follow-up	1,863	42.30	8,879	35.04
7. No type 1 diabetes in the 12 months prior to the index date	81	1.84	384	1.52
8. No gestational diabetes in the 12 months prior to the index date	3	0.07	31	0.12
9. No pregnancy in the 12 months prior to the index date	15	0.34	110	0.43
Number 1–5 and not number 6–9	664	15.08	3,283	12.96

Notes: Bold text indicates final study sample sizes based on the application of criteria #1–5 and not meeting criteria 6–9.

Abbreviations: A1C, glycated hemoglobin; GLP-1, glucagon-like peptide-1; QD, once daily; QW, once weekly.

Table 2 Baseline patient demographics

	Exenatide QW (N=664)	Liraglutide QD (N=3,283)	P-value
Age (years), mean (SD)	58.01 (10.97)	58.12 (11.05)	0.8274
Female, n (%)	320 (48.19%)	1,781 (54.25%)	0.0043
Race,* n (%)
White	472 (71.08%)	2,240 (68.23%)	0.0197
Black	39 (5.87%)	261 (7.95%)
Hispanic	16 (2.41%)	121 (3.69%)
Asian	14 (2.11%)	34 (1.04%)
Unknown/Other	123 (18.52%)	627 (19.10%)
A1C, mean (SD) (% missing)	8.4 (1.65) (0.0%)	8.4 (1.61) (0.0%)	0.2211
BMI (kg/m^2), mean (SD) (%)	37.8 (8.17) (3.0%)	38.0 (7.92) (3.0%)	0.6613
Laboratory values and vital signs, mean (SD) (% with no test result)
Total cholesterol	168.1 (42.14) (37.2%)	171.4 (43.02) (37.4%)	0.1355
Systolic blood pressure	127.6 (15.57) (1.2%)	129.6 (15.79) (1.2%)	0.0041
Triglycerides	205.4 (143.49) (36.4%)	205.6 (175.52) (37.5%)	0.9823
HDL	41.9 (11.14) (38.1%)	42.6 (12.33) (37.6%)	0.3123
LDL	87.7 (33.64) (51.2%)	91.3 (34.98) (52.3%)	0.0868
Geographic region,* n (%)
Northeast	138 (20.78%)	847 (25.80%)	0.0236
Midwest	128 (19.28%)	646 (19.68%)
South	323 (48.64%)	1,415 (43.10%)
West	75 (11.30%)	375 (11.42%)
Health plan type, n (%)
Commercial	215 (32.38%)	1,077 (32.81%)	0.1233
Medicare	144 (21.69%)	819 (24.95%)
Other**	305 (45.93%)	1,387 (42.25%)

Notes:

* P<0.05 between patients initiating exenatide QW and liraglutide QD;

** other = self-pay, unknown, missing. Student’s t-tests and chi-square tests were performed to compare exenatide QW and liraglutide QD.

Abbreviations: A1C, glycated hemoglobin; BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; QD, once daily; QW, once weekly; SD, standard deviation.

Table 3 Baseline clinical characteristics and comorbidities

	Exenatide QW (N=664)	Liraglutide QD (N=3,283)	P-value
Deyo–Charlson comorbidity index, mean (SD)	2.2 (1.80)	2.3 (1.71)	0.1856
Diabetes severity indicator, n (%)
Diabetic retinopathy	11 (1.66%)	28 (0.85%)	0.0562
Peripheral neuropathy	8 (1.20%)	34 (1.04%)	0.6984
Renal impairment	20 (3.01%)	104 (3.17%)	0.8338
Comorbidities, n (%)
Hyperlipidemia (DX or RX)	466 (70.18%)	2,398 (73.04%)	0.1317
Hypertension (DX or RX)	495 (74.55%)	2,430 (74.02%)	0.7759
Ischemic heart disease	18 (2.71%)	81 (2.47%)	0.7143
Congestive heart failure	5 (0.75%)	18 (0.55%)	0.5273
Hypertriglyceridemia	5 (0.75%)	20 (0.61%)	0.6701
Acute coronary syndrome	2 (0.30%)	10 (0.30%)	0.9884
Arthritis*	57 (8.58%)	430 (13.10%)	0.0023
Obesity	45 (6.78%)	263 (8.01%)	0.0967

Notes:

* P<0.05 between patients initiating exenatide QW and liraglutide QD. Student’s t-tests and chi-square tests were performed to compare exenatide QW and liraglutide QD.

Abbreviations: QD, once daily; QW, once weekly; SD, standard deviation; DX, diagnosis; RX, determined by prescriptions.

Table 4 Baseline oral antihyperglycemic drugs prior to initiation of GLP-1RAs#

	Exenatide QW (N=664)	Liraglutide QD (N=3,283)	P-value
Oral antihyperglycemic drugs, n (%)
Biguanides (metformin)	430 (64.76%)	2,177 (66.31%)	0.884
DPP-4 inhibitors	194 (29.22%)	906 (27.60%)	0.087
Sulfonylureas	302 (45.48%)	1,485 (45.23%)	0.845
TZDs*	147 (22.14%)	593 (18.06%)	0.012
Insulin	275 (41.42%)	1,454 (44.29%)	0.078
Number of antihyperglycemic drug classes, n (%)
0	32 (4.82%)	141 (4.29%)	0.926
1	104 (15.66%)	590 (17.97%)
2	209 (31.48%)	1,069 (32.56%)
3+	319 (48.04%)	1,483 (45.17%)

Notes:

# Antihyperglycemic drug use within 365 days prior to the index date;

* P<0.05 between patients initiating exenatide QW and liraglutide QD. Student’s t-tests and chi-square tests were performed to compare exenatide QW and liraglutide QD.

Abbreviations: DPP-4, dipeptidyl peptidase-4; GLP-1RAs, glucagon-like peptide-1 receptor agonists; QD, once daily; QW, once weekly; TZDs, thiazolidinediones.

Table 5 Baseline and follow-up secondary outcomes, unadjusted results

Value	Exenatide QW			Liraglutide QD			P-value
	N	Mean	SD	N	Mean	SD
Baseline BMI (kg/m^2)	608	37.56	7.87	2,976	37.76	7.83	0.5753
Post-BMI	608	36.78	7.89	2,976	37.00	7.75	0.5290
Change in BMI	608	−0.78	2.06	2,976	−0.76	2.29	0.8100
Baseline weight (lbs)	618	238.70	58.31	3,011	237.90	54.13	0.7600
Post-weight	618	234.00	57.97	3,011	232.70	54.37	0.5968
Change in weight	618	−4.63	30.63	3,011	−5.20	15.93	0.6566
Baseline total cholesterol (mg/dL)	270	169.90	44.39	1,350	173.90	44.42	0.1773
Post-total cholesterol	270	161.60	43.12	1,350	166.30	41.86	0.0976
Change in total cholesterol	270	−8.23	34.91	1,350	−7.58	37.76	0.7933
Baseline systolic blood pressure (mmHg)	626	126.80	14.20	3,044	129.00	15.64	0.0006
Post-systolic blood pressure	626	126.70	15.04	3,044	127.30	14.89	0.3063
Change in systolic blood pressure	626	−0.15	16.18	3,044	−1.68	17.15	0.0409
Baseline triglycerides (mg/dL)	277	210.80	156.30	1376	212.50	187.60	0.8774
Post-triglycerides	277	184.40	127.80	1376	191.40	152.30	0.4172
Change in triglycerides	277	−26.46	124.90	1376	−21.04	171.60	0.5385
Baseline HDL (mg/dL)	268	41.96	10.94	1350	42.46	12.24	0.5065
Post-HDL	268	42.03	11.01	1350	42.33	11.56	0.6996
Change in HDL	268	0.07	6.08	1350	−0.13	7.62	0.6380
Baseline LDL (mg/dL)	218	89.88	35.09	999	93.40	35.80	0.1866
Post-LDL	218	84.47	36.42	999	89.20	34.19	0.0672
Change in LDL	218	−5.41	27.91	999	−4.20	31.92	0.5716

Notes:P-values based on Student’s t-test.

Abbreviations: BMI, body mass index; HDL, high-density lipoprotein; LDL, low-density lipoprotein; QD, once daily; QW, once weekly; SD, standard deviation.

Figure 1 Adjusted models comparing the mean change in A1C from baseline to 6 months.

Notes: *Patients not at goal (A1C ≥7%) at baseline and had no pre-index insulin use; **adjusted for age, sex, race, baseline A1C, body mass index, number of other antidiabetes medication classes, Deyo–Charlson comorbidity index, insurance type, region, hyperlipidemia, and hypertension.
Abbreviations: A1C, glycated hemoglobin; QD, once daily; QW, once weekly; SD, standard deviation.