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Characterization of Interchanging Incretin Analogs in Clinical Practice: A Descriptive Report
Christopher M Hvisdas1, Natalie D Goode1, Diane H Kim1
1Department of Pharmacy, Penn Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
Summary
Incretin analog interchanges were well-tolerated by 96% of patients, with a defined process reducing time to maximum dose. This study confirms safe and effective incretin analog switching in outpatient settings.
Area of Science:
- Endocrinology
- Pharmacology
Background:
- Incretin analogs are crucial for managing type 2 diabetes.
- Medication shortages and therapy adjustments necessitate effective interchange protocols.
- Standardized protocols ensure patient safety and treatment continuity.
Purpose of the Study:
- To assess the tolerability of switching between incretin analogs to equipotent or higher doses.
- To evaluate a structured interchange process in an adult outpatient setting.
- To provide data supporting safe and effective incretin analog therapy adjustments.
Main Methods:
- Retrospective chart review of adult patients from January to November 2022.
- Development of an incretin analog equivalency table and interchange protocol.
- Inclusion of patients who underwent a recommended interchange and tolerability assessment.
Main Results:
- 96% of 156 patients tolerated the incretin analog interchange.
- Common interchanges (dulaglutide to tirzepatide) showed 93% tolerability.
- Prior authorizations were required for 74% of new therapies; time to maximum dose reduced by a median of 3 months.
- Only 7 patients experienced adverse events (gastrointestinal or injection site reactions).
Conclusions:
- The characterized interchange process for incretin analogs is effective and well-tolerated.
- High tolerability supports the use of this defined interchange protocol.
- Further research should confirm the safety and efficacy of incretin analog interchanges.
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