Outcomes in GLP-1 RA-Experienced Patients Switching to Once-Weekly Semaglutide in a Real-World Setting: The Retrospective, Observational EXPERT Study

Ildiko Lingvay; Andreas R. Kirk; Søren Lophaven; Michael L. Wolden; Jay H. Shubrook

doi:10.1007/s13300-021-01010-4

Outcomes in GLP-1 RA-Experienced Patients Switching to Once-Weekly Semaglutide in a Real-World Setting: The Retrospective, Observational EXPERT Study

Ildiko Lingvay, Andreas R. Kirk, Søren Lophaven, Michael L. Wolden, Jay H. Shubrook

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are highly effective for glycaemic control and weight loss in patients with type 2 diabetes (T2D). In this retrospective, observational study, we analysed glycated haemoglobin (HbA1c) and weight following switching to semaglutide from any other GLP-1 RA, using US electronic health records and prescription data. Methods: Adults (≥ 18 years old) with T2D required at least one prescription for injectable semaglutide at index date (treatment switch), at least one prescription for any other GLP-1 RA in the previous 365 days, a baseline HbA1c and/or weight measurement in the 90 days pre-index and a follow-up measurement at 180 and 365 days post-index. HbA1c and weight cohorts were analysed separately using an ANCOVA model. Sensitivity analyses were conducted in patients with at least two prescriptions for pre-switch GLP-1 RA. A secondary analysis compared subgroups receiving different GLP-1 RAs pre-switch. Results: Patients with HbA1c (n = 710) and weight (n = 921) data had similar baseline characteristics. Significant reductions in HbA1c at 6 months (0.7%; 95% confidence interval [CI] − 0.8, − 0.6) were sustained at 12 months. Weight reductions were significant at 6 months (− 2.1 kg; 95% CI − 2.6, − 1.6) and greater at 12 months (− 2.8 kg; 95% CI − 3.9, − 1.8). These patterns were consistent with the two-prescription sensitivity analysis and independent of the pre-switch GLP-1 RA. Conclusion: Switching to injectable semaglutide from any other GLP-1 RA was associated with significant improvements in glycaemic control and weight. Our findings support decision-making in clinical practice in patients with an indication to switch between GLP-1 RAs.

Original language	English (US)
Pages (from-to)	879-896
Number of pages	18
Journal	Diabetes Therapy
Volume	12
Issue number	3
DOIs	https://doi.org/10.1007/s13300-021-01010-4
State	Published - Mar 2021

Keywords

Database research
GLP-1 receptor agonists
Glycaemic control
Observational study
Type 2 diabetes
Weight loss

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism

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10.1007/s13300-021-01010-4

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@article{3f86ae0700614acfb3a701bc319e88dd,

title = "Outcomes in GLP-1 RA-Experienced Patients Switching to Once-Weekly Semaglutide in a Real-World Setting: The Retrospective, Observational EXPERT Study",

abstract = "Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are highly effective for glycaemic control and weight loss in patients with type 2 diabetes (T2D). In this retrospective, observational study, we analysed glycated haemoglobin (HbA1c) and weight following switching to semaglutide from any other GLP-1 RA, using US electronic health records and prescription data. Methods: Adults (≥ 18 years old) with T2D required at least one prescription for injectable semaglutide at index date (treatment switch), at least one prescription for any other GLP-1 RA in the previous 365 days, a baseline HbA1c and/or weight measurement in the 90 days pre-index and a follow-up measurement at 180 and 365 days post-index. HbA1c and weight cohorts were analysed separately using an ANCOVA model. Sensitivity analyses were conducted in patients with at least two prescriptions for pre-switch GLP-1 RA. A secondary analysis compared subgroups receiving different GLP-1 RAs pre-switch. Results: Patients with HbA1c (n = 710) and weight (n = 921) data had similar baseline characteristics. Significant reductions in HbA1c at 6 months (0.7%; 95% confidence interval [CI] − 0.8, − 0.6) were sustained at 12 months. Weight reductions were significant at 6 months (− 2.1 kg; 95% CI − 2.6, − 1.6) and greater at 12 months (− 2.8 kg; 95% CI − 3.9, − 1.8). These patterns were consistent with the two-prescription sensitivity analysis and independent of the pre-switch GLP-1 RA. Conclusion: Switching to injectable semaglutide from any other GLP-1 RA was associated with significant improvements in glycaemic control and weight. Our findings support decision-making in clinical practice in patients with an indication to switch between GLP-1 RAs.",

keywords = "Database research, GLP-1 receptor agonists, Glycaemic control, Observational study, Type 2 diabetes, Weight loss",

author = "Ildiko Lingvay and Kirk, {Andreas R.} and S{\o}ren Lophaven and Wolden, {Michael L.} and Shubrook, {Jay H.}",

note = "Funding Information: This study and the publication fees were funded by Novo Nordisk A/S. Funding Information: This study and the publication fees were funded by Novo Nordisk A/S. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. The authors acknowledge the medical writing assistance of Caroline Freeman of Oxford PharmaGenesis, Oxford, UK (funded by Novo Nordisk A/S). An earlier iteration of these analyses was presented at the American Diabetes Association 80th Scientific Sessions: A Virtual Experience; 12?16 June 2020. Ildiko Lingvay has performed consultancy for AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Janssen Pharmaceuticals, Inc., MannKind Corporation, Novo Nordisk A/S, Sanofi, TARGET PharmaSolutions and Valeritas, Inc. Andreas R. Kirk is an employee and shareholder of Novo Nordisk A/S. S?ren Lophaven is employed as a consultant by Novo Nordisk A/S. Michael L. Wolden is an employee and shareholder of Novo Nordisk A/S. Jay H. Shubrook has participated in advisory panels for Bayer US, Eli Lilly and Company, Novo Nordisk Inc. and Sanofi US. Approval by an ethics committee was not required for this study because only de-identified secondary data were used. This is a commercial database and the datasets were accessed through a licence with IBM. The datasets analysed during the current study are not publicly available because they are under licence from IBM. Aggregate data are available from the authors upon reasonable request. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = mar,

doi = "10.1007/s13300-021-01010-4",

language = "English (US)",

volume = "12",

pages = "879--896",

journal = "Diabetes Therapy",

issn = "1869-6953",

publisher = "Springer Publishing Company",

number = "3",

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TY - JOUR

T1 - Outcomes in GLP-1 RA-Experienced Patients Switching to Once-Weekly Semaglutide in a Real-World Setting

T2 - The Retrospective, Observational EXPERT Study

AU - Lingvay, Ildiko

AU - Kirk, Andreas R.

AU - Lophaven, Søren

AU - Wolden, Michael L.

AU - Shubrook, Jay H.

N1 - Funding Information: This study and the publication fees were funded by Novo Nordisk A/S. Funding Information: This study and the publication fees were funded by Novo Nordisk A/S. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. The authors acknowledge the medical writing assistance of Caroline Freeman of Oxford PharmaGenesis, Oxford, UK (funded by Novo Nordisk A/S). An earlier iteration of these analyses was presented at the American Diabetes Association 80th Scientific Sessions: A Virtual Experience; 12?16 June 2020. Ildiko Lingvay has performed consultancy for AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Janssen Pharmaceuticals, Inc., MannKind Corporation, Novo Nordisk A/S, Sanofi, TARGET PharmaSolutions and Valeritas, Inc. Andreas R. Kirk is an employee and shareholder of Novo Nordisk A/S. S?ren Lophaven is employed as a consultant by Novo Nordisk A/S. Michael L. Wolden is an employee and shareholder of Novo Nordisk A/S. Jay H. Shubrook has participated in advisory panels for Bayer US, Eli Lilly and Company, Novo Nordisk Inc. and Sanofi US. Approval by an ethics committee was not required for this study because only de-identified secondary data were used. This is a commercial database and the datasets were accessed through a licence with IBM. The datasets analysed during the current study are not publicly available because they are under licence from IBM. Aggregate data are available from the authors upon reasonable request. Publisher Copyright: © 2021, The Author(s).

PY - 2021/3

Y1 - 2021/3

N2 - Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are highly effective for glycaemic control and weight loss in patients with type 2 diabetes (T2D). In this retrospective, observational study, we analysed glycated haemoglobin (HbA1c) and weight following switching to semaglutide from any other GLP-1 RA, using US electronic health records and prescription data. Methods: Adults (≥ 18 years old) with T2D required at least one prescription for injectable semaglutide at index date (treatment switch), at least one prescription for any other GLP-1 RA in the previous 365 days, a baseline HbA1c and/or weight measurement in the 90 days pre-index and a follow-up measurement at 180 and 365 days post-index. HbA1c and weight cohorts were analysed separately using an ANCOVA model. Sensitivity analyses were conducted in patients with at least two prescriptions for pre-switch GLP-1 RA. A secondary analysis compared subgroups receiving different GLP-1 RAs pre-switch. Results: Patients with HbA1c (n = 710) and weight (n = 921) data had similar baseline characteristics. Significant reductions in HbA1c at 6 months (0.7%; 95% confidence interval [CI] − 0.8, − 0.6) were sustained at 12 months. Weight reductions were significant at 6 months (− 2.1 kg; 95% CI − 2.6, − 1.6) and greater at 12 months (− 2.8 kg; 95% CI − 3.9, − 1.8). These patterns were consistent with the two-prescription sensitivity analysis and independent of the pre-switch GLP-1 RA. Conclusion: Switching to injectable semaglutide from any other GLP-1 RA was associated with significant improvements in glycaemic control and weight. Our findings support decision-making in clinical practice in patients with an indication to switch between GLP-1 RAs.

AB - Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are highly effective for glycaemic control and weight loss in patients with type 2 diabetes (T2D). In this retrospective, observational study, we analysed glycated haemoglobin (HbA1c) and weight following switching to semaglutide from any other GLP-1 RA, using US electronic health records and prescription data. Methods: Adults (≥ 18 years old) with T2D required at least one prescription for injectable semaglutide at index date (treatment switch), at least one prescription for any other GLP-1 RA in the previous 365 days, a baseline HbA1c and/or weight measurement in the 90 days pre-index and a follow-up measurement at 180 and 365 days post-index. HbA1c and weight cohorts were analysed separately using an ANCOVA model. Sensitivity analyses were conducted in patients with at least two prescriptions for pre-switch GLP-1 RA. A secondary analysis compared subgroups receiving different GLP-1 RAs pre-switch. Results: Patients with HbA1c (n = 710) and weight (n = 921) data had similar baseline characteristics. Significant reductions in HbA1c at 6 months (0.7%; 95% confidence interval [CI] − 0.8, − 0.6) were sustained at 12 months. Weight reductions were significant at 6 months (− 2.1 kg; 95% CI − 2.6, − 1.6) and greater at 12 months (− 2.8 kg; 95% CI − 3.9, − 1.8). These patterns were consistent with the two-prescription sensitivity analysis and independent of the pre-switch GLP-1 RA. Conclusion: Switching to injectable semaglutide from any other GLP-1 RA was associated with significant improvements in glycaemic control and weight. Our findings support decision-making in clinical practice in patients with an indication to switch between GLP-1 RAs.

KW - Database research

KW - GLP-1 receptor agonists

KW - Glycaemic control

KW - Observational study

KW - Type 2 diabetes

KW - Weight loss

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JO - Diabetes Therapy

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Outcomes in GLP-1 RA-Experienced Patients Switching to Once-Weekly Semaglutide in a Real-World Setting: The Retrospective, Observational EXPERT Study

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