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Once-weekly dulaglutide bests semaglutide or exenatide in patient adherence and persistence
INDIANAPOLIS - New real-world data showed Trulicity® (dulaglutide) had significantly higher adherence and longer persistence compared to weekly injections of semaglutide or exenatide (BCise pen) in people with type 2 diabetes new to GLP-1 receptor agonist (RA) treatment. Eli Lilly and Company (NYSE: LLY) presented these data today during the American Diabetes Association's (ADA) 80th Scientific Sessions®.
The real-world study comparing adherence and persistence used U.S. claims data of people with type 2 diabetes initiating weekly injectable treatment with Trulicity, semaglutide or exenatide. Matched cohorts were well balanced for characteristics such as age, gender, adapted Diabetes Complications Severity Index (aDCSI) score and select comorbidities.
At six months, people taking Trulicity showed higher adherence and persistence than those taking semaglutide or exenatide. Further, significantly fewer people discontinued treatment with Trulicity compared to semaglutide or exenatide.1
Trulicity versus injectable semaglutide:
1. Adherence: 59.7 percent (Trulicity) versus 42.7 percent (semaglutide).
2. Persistence: 143.6 days (Trulicity) versus 129.9 days (semaglutide).
3. Treatment discontinuation: 30.8 percent (Trulicity) versus 40.8 percent (semaglutide).
Trulicity versus exenatide:
1. Adherence: 58.1 percent (Trulicity) versus 40.3 percent (exenatide).
2. Persistence: 142 days (Trulicity) versus 121.4 days (exenatide).
3. Treatment discontinuation: 32.1 percent (Trulicity) versus 49.4 percent (exenatide).
"Type 2 diabetes is a progressive and personal condition and real-world studies are critical to help us further understand people's experiences with the condition and treatment," said Leonard Glass, M.D., F.A.C.E., vice president of Medical Affairs, Lilly. "This real-world study reinforces the value of the simple approach of once-weekly Trulicity and the long-term impact it can have on not only the treatment experience of people with diabetes, but also on outcomes."
About the Adherence and Persistence Study
The retrospective, real-world, observational study used U.S. claims from the HealthCore Integrated Research Database (HIRD®) between August 2017 and June 2019 and the primary objective was to compare adherence and persistence over six months among people with type 2 diabetes initiating once-weekly glucagon-like peptide-1 receptor agonists, Trulicity (1.5 mg and 0.75 mg) to semaglutide (1 mg and 0.25/0.5 mg) and exenatide. Kaplan-Meier plot and Cox Proportional Hazard model were used to examine medication persistence. Trulicity users were propensity-matched 1:1 to semaglutide users (3,852 pairs) or exenatide users (1,879 pairs) users. Matched cohorts were balanced in baseline characteristics. People studied were 18 years or older and matched according to characteristics including baseline age, gender, aDCSI score and select comorbidities.
PURPOSE AND SAFETY SUMMARY WITH WARNINGS
Important Facts About Trulicity® (Trῡ-li-si-tee). It is also known as dulaglutide.
TRULICITY is an injectable prescription medicine for adults with type 2 diabetes used to improve blood sugar (glucose) and used to reduce the risk of major cardiovascular events such as death, heart attack, or stroke in people who have heart disease or multiple cardiovascular risk factors.
1. You take it once a week by injecting it under the skin of your stomach, thigh, or upper arm. Use Trulicity together with the diet and exercise that your doctor recommends. Trulicity is not insulin.
Warnings
Trulicity may cause tumors in the thyroid, including thyroid cancer. Watch for possible symptoms, such as a lump or swelling in the neck, trouble swallowing, hoarseness, or shortness of breath. If you have a symptom, tell your doctor.
1. Do not use Trulicity if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC).
2. Do not use Trulicity if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
3. Do not use Trulicity if you are allergic to dulaglutide or other ingredients in Trulicity.
Ask your doctor how to recognize the serious side effects below and what to do if you think you have one:
Inflamed pancreas (pancreatitis). Stop using Trulicity and call your healthcare provider right away if you have severe pain in your stomach area (abdomen), with or without vomiting, that will not go away. You may feel the pain from your abdomen to your back.
Changes in vision. Tell your healthcare provider if you have changes in vision during treatment with Trulicity.
Low blood sugar (hypoglycemia). Signs and symptoms of low blood sugar may include dizziness or light-headedness, confusion or drowsiness, headache, blurred vision, slurred speech, fast heartbeat, sweating, hunger, shakiness, feeling jittery, weakness, anxiety, irritability or mood changes.
Serious allergic reactions. Stop using Trulicity and get medical help right away if you have any symptoms of a serious allergic reaction which may include: swelling of your face, lips, tongue or throat, problems breathing or swallowing, severe rash or itching, fainting or feeling dizzy, or very rapid heartbeat.
Acute kidney injury. In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration). This may cause kidney problems to get worse.
Severe stomach problems. Trulicity may cause stomach problems, which could be severe.
Common side effects
The most common side effects of Trulicity include nausea, diarrhea, vomiting, abdominal pain and decreased appetite.
These are not all the possible side effects of Trulicity.
Tell your doctor if you have any side effects. You can report side effects at 1-800-FDA-1088 or www.fda.gov/medwatch.
Before using
1. Your healthcare provider should show you how to use Trulicity before you use it for the first time.
2. Before you use Trulicity, talk to your doctor about low blood sugar and how to manage it.
Review these questions with your doctor:
1. Do you have other medical conditions, including problems with your pancreas, kidneys, liver, or stomach, or have a history of diabetic retinopathy?
2. Do you take other diabetes medicines, such as insulin or sulfonylureas?
3. Do you take any other prescription medicines or over-the-counter drugs, vitamins or herbs?
Review the list below with your doctor. Trulicity may not be right for you if:
1. You are pregnant or plan to become pregnant or breastfeeding or plan to breastfeed.
2. You have type 1 diabetes or diabetic ketoacidosis.
3. You have or have had an inflamed pancreas (pancreatitis).
4. You have severe intestinal or stomach problems, such as slowed emptying or problems with digesting food.
5. You are a child under 18 years old.
How to take
1. Read the Instructions for Use that come with Trulicity.
2. Use Trulicity exactly as your doctor says.
3. Do not share your Trulicity pen, syringe or needles with another person.
4. Do not give Trulicity to other people.
5. If you take too much Trulicity, call your healthcare provider or seek medical advice promptly.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751