An observational study evaluating effectiveness and therapeutic adherence in patients with Type 2 Diabetes initiating dulaglutide vs. subcutaneous semaglutide in Spain

Abstract

[eng] Aims To evaluate in a real-world setting the effectiveness and adherence of weekly Dulaglutide and subcutaneous (sc) Semaglutide in patients with Type 2 Diabetes Mellitus (T2DM). Methods Single-centre retrospective observational study comparing glucose reduction (change from baseline of Fasting Plasma Glucose - FPG, and HbA1c) and weight reduction (absolute change in weight from baseline and % weight reduction) in patients initiating Dulaglutide (n=183) or sc Semaglutide (n=115) during an index period of 18 months. Safety, adherence to and persistence on index drug were also evaluated. Results Patients initiating Dulaglutide were older, had a longer diabetes duration and higher baseline FPG (180 vs. 165 mg/dl) and HbA1c (8.2 vs 7.84%) and were prescribed more insulin and sulfonylurea and less SGLT-2 inhibitors vs. patients on sc Semaglutide. After a median follow-up period of 9.37 months, both drugs reduced FPG by 43.18 mg/dl (Dulaglutide) and 48.36 mg/dl (sc Semaglutide); and HbA1c by 1.03% and 1.36%, respectively. Both drugs were associated to a weight loss of 5.63 kg (5.83% baseline weight) (Dulaglutide) and 7.6 kg (7.56%) (sc Semaglutide). Baseline age, duration of diabetes, BMI and HbA1c significantly influenced outcomes. Therapeutic adherence and persistence were similar for both drugs. Up to 95% of patients on Dulaglutide used 1.5 mg dose and 72% of patients on sc Semaglutide used 1.0 mg dose. Conclusions In a pragmatic setting and acknowledging important differences in baseline characteristics and background antidiabetic therapy that might drive specific drug prescription, both Dulaglutide and sc Semaglutide confirm a robust effect on glucose and weight reduction with a similar therapeutic adherence.