Persistence of GLP-1 RA in combination with basal insulin among adults with type 2 diabetes in Canada

• Published in: Diabetes research and clinical practice Vol. 177; p. 108920
• Main Authors: Abitbol, Alexander, Siemens, Rick, Nightingale, Natalie, Stewart, John, Toutounji, Marie-Josée, Goldenberg, Ronald
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.07.2021
• Subjects: Basal Insulin; GLP-1 Receptor Agonist; Loose Combination; Persistence; Type 2 Diabetes; Persistence; Basal Insulin; GLP-1 Receptor Agonist; Loose Combination; Type 2 Diabetes
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2021.108920

The purpose of this study is to assess the persistence of Canadians with Type 2 diabetes mellitus (T2D) on loose-dose combination treatment (i.e., administered by separate devices) with a glucagon-like peptide 1 receptor agonist (GLP-1 RA) and basal insulin over 12 months. This study is a retrospective cohort study of T2D adults using a Canadian longitudinal prescription database over a 5-year period. Cohort 1 (n = 12,411) is a primary cohort including only individuals inexperienced with the combination therapy at index. Cohort 2 (n = 13,498) is an exploratory cohort and includes everyone regardless of previous experience on the loose-dose combination therapy. The primary endpoint is the proportion of individuals persistent and average days persistent to the loose-dose combination therapy at 12 months in Canada. In Cohort 1, overall persistence was 47% in the 12-month period post-index. Persistence is similar when including all inexperienced and subsequent loose-dose combination experiences in Cohort 2 (45%). Canadian T2D adults taking a loose-dose combination therapy of a GLP-1 RA and basal insulin had overall low persistence and lower than reports from previous studies of GLP-1 RA or basal insulin alone. Improving persistence to combination therapy with GLP-1 RA plus basal insulin is an important issue to explore in clinical practice.