Higher Rates of Persistence and Adherence in Patients with Type 2 Diabetes Initiating Once-Weekly vs Daily Injectable...

Area of Science:

• Endocrinology
• Pharmacology
• Clinical Practice

Background:

• Reducing dosing frequency can decrease treatment burden and enhance patient persistence and adherence.
• Type 2 diabetes (T2D) management often involves injectable therapies with varying dosing schedules.

Purpose of the Study:

• To compare persistence and adherence in T2D patients initiating once-weekly versus daily injectable glucagon-like peptide-1 receptor agonists (GLP-1 RAs).
• To evaluate the potential benefits of long-acting GLP-1 RAs for patients with more advanced T2D.

Main Methods:

• Retrospective observational study using US claims and EMR data (IBM MarketScan Explorys).
• Propensity score matching (1:1) for baseline characteristics of T2D patients initiating once-weekly or daily injectable GLP-1 RAs.
• Assessed persistence via Kaplan-Meier and Cox models; adherence defined as proportion of days covered ≥0.8.
• Inverse probability of treatment weighting (IPTW) used to match patients to basal insulin initiators.

Main Results:

• Once-weekly GLP-1 RAs demonstrated significantly higher persistence (median 333 vs 269 days; HR 0.80) and adherence (≥0.8 proportion of days covered) at 6 and 12 months compared to daily regimens.
• Greater mean reductions in glycated hemoglobin (HbA1c) observed with once-weekly treatments at 6 months (-1.1% vs -0.9%) and 12 months (-0.9% vs -0.7%).
• Adherent patients showed greater HbA1c reductions than non-adherent patients, with similar findings in IPTW-matched analyses.

Conclusions:

• Once-weekly injectable GLP-1 RAs are associated with superior persistence and adherence over one year in US clinical practice compared to daily formulations.
• The findings suggest that once-weekly GLP-1 RAs may offer particular advantages for patients with more advanced type 2 diabetes.