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Adherence and Persistence Among Individuals Living With Type 2 Diabetes and Using a Free Combination of Basal Insulin
Takeshi Miyatsuka1, James Brash2, Eleanor Davies2
1Department of Diabetes, Endocrinology and Metabolism, Kitasato University School of Medicine, Sagamihara, Japan.
Aim:
To investigate adherence to and persistence with free combination therapy (daily basal insulin plus an injectable glucagon-like peptide-1 receptor agonist [GLP-1 RA]) versus fixed-ratio combination (FRC) therapy (basal insulin plus a GLP-1 RA) among individuals with type 2 diabetes (T2D) in Japan.
Materials And Methods:
This retrospective, observational cohort study used DeSC-IQVIA Integrated claims data from Japan to identify adults (aged ≥ 18 years) with confirmed T2D and ≥ 1 prescription for a GLP-1 RA (with predefined basal insulin persistence window) or an FRC during October 2019 to September 2023. Study index was date of first GLP-1 RA or FRC prescription; follow-up was 365 days. The primary objective was to evaluate adherence to and persistence with free combination therapy versus FRC therapy.
Results:
Age (mean [standard deviation]) at index was statistically significantly higher in the free combination group (67.0 [13.85] years, n = 2063) than in the FRC group (65.7 [13.85] years, n = 2386) (p = 0.002). Odds of optimal adherence at end of follow-up were statistically significantly higher with FRC therapy than with free combination therapy (adjusted odds ratio [95% confidence interval]: 1.96 [1.73-2.23]; p < 0.001). Risk of discontinuation by end of follow-up was statistically significantly lower with FRC therapy than with free combination therapy (adjusted hazard ratio [95% confidence interval]: 0.66 [0.61-0.71]; p < 0.001). Adherence and persistence findings were similar in elderly individuals.
Conclusions:
In this real-world, adult population with T2D in Japan, FRC therapy was associated with improved adherence and persistence versus free combination therapy.
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