Real-world GLP-1 receptor agonist persistence improved with weekly formulation
medwireNews: The real-world STAY study suggests that people take glucagon-like peptide (GLP)-1 receptor agonists more consistently and for longer if given a weekly rather than daily formulation.
People using a weekly injectable GLP-1 receptor agonist continued to take their medication for a median of 333 days, compared with 269 days for matched people using daily injections.
This represented a significant 20% reduced likelihood of discontinuation with a weekly injection, presenter Bill Polonsky (Behavioral Diabetes Institute, San Diego, California, USA) told delegates at the virtual 57th EASD Annual Meeting.
In addition, during the first 6 months of use, 54% of people using a weekly injectable acquired sufficient medication to cover at least 80% of usage days, compared with 44% of those using daily injections, equating to a significant 23% difference.
After 12 months, usage had fallen overall but remained a significant 35% higher with weekly versus daily injections, at 46% versus 34%.
The study participants were identified in a US insurance claims database and narrowed down to those with data from 6 months before and 12 months after starting a GLP-1 receptor agonist. This yielded a total of 784 users of weekly formulations and an equal number who used daily formulations, matched on baseline characteristics including age, sex, glycated hemoglobin (HbA1c) level, bodyweight, comorbidities, and use of other medications.
Among these participants, use of a weekly rather than daily GLP-1 receptor agonist was associated with larger reductions in HbA1c, with this most notable among people with at least 80% usage. At 6 months, for example, average HbA1c reductions were 1.3% versus 1.0% with weekly versus daily GLP-1 receptor agonists in this subgroup, but 0.8% and 0.7%, respectively, in the subgroup with less consistent use.
“Our study provides evidence that adherence and persistence, which are typically considered to be linked to patient convenience, also – very importantly – have clear clinical benefits,” said Polonsky.
Addressing the overall low medication persistence in the study, irrespective of injection frequency, the presenter attributed this partly to the need for people to continue taking medications despite the lack of an “immediate, tangible outcome,” noting that “the major important outcomes of course are the absence of terrible problems happening in the long term.”
People therefore discontinue medications because “they don’t perceive them as being worthwhile over the course of time,” said Polonsky.
But he noted that the newest and forthcoming medications, such as tirzepatide and high doses of GLP-1 receptor agonists, “have such powerful, tangible impacts on our patients,” and added: “My hope is that we’re going to be seeing better adherence and persistence.”
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