According to a real-world outcomes analysis among patients with type 2 diabetes mellitus, treatment with insulin glargine and liraglutide appeared to be prescribed for different patient groups, “highlighting that efficacy results from clinical trials do not always translate into real-world practice,” stated study author Wenhui Wei, PhD, MS, MBA. Findings from the study are published in Diabetes, Obesity and Metabolism.
Dr. Wei and coauthors set out to examine real-world outcomes in patients with type 2 diabetes mellitus starting injectable therapy as part of the INITIATOR (Initiation of New Injectable Treatment Introduced after Antidiabetic Therapy with Oral-only Regimens) study. They analyzed insurance claims and medical record data among adults starting treatment with insulin glargine or liraglutide. Patients’ baseline characteristics and changes in 12-month follow-up outcomes (HbA1c, weight change, hypoglycemia, persistence, healthcare utilization and costs) were compared for both treatment groups.
The study included 2,116 patients in the glargine group and 2,374 patients in the liraglutide group. Patients in the glargine group exhibited significantly higher baseline HbA1c vs. liraglutide patients (9.72% vs. 8.19%; P<0.001), a lower risk of having HbA1c <7% (7.1% vs. 23.8%; P<0.001), a lower body weight (100.9kg vs. 110.9kg; P<0.001), a higher Charlson Comorbidity Index score (0.88 vs. 0.63; P<0.001). Patients treated with glargine also incurred higher diabetes-related costs vs. liraglutide-treated patients ($3,492 vs. $2,089; P<0.001).
During the 12-month follow-up period, glargine-treated patients showed greater treatment persistence (64% vs. 49%) and a greater mean HbA1c reduction vs. liraglutide-treated patients (–1.24% vs. –0.51%) . However, glargine-treated patients saw a +1.17kg weight gain whereas liraglutide-treated patients had a –2.74kg loss. Change in diabetes-related costs from baseline was increased significantly for liraglutide-patients ($2,08 vs. $3,258; P<0.001) but not for glargine-treated patients ($3,492 vs. $3,550; P=0.890).
Clinically relevant baseline differences were seen in both treatment arms. The increases in costs among the liraglutide-treatment group calls for more cost-effectiveness analysis, concluded Dr. Wei.
For more information visit onlinelibrary.wiley.com.