OBJECTIVES

: In both randomized controlled trials and the real world, liraglutide has demonstrated both glycemic and weight benefits in patients with type 2 diabetes mellitus (T2DM); however, long-term persistence to injected drugs is challenging. In this study, we examined the association of long-term continuation of liraglutide and metabolic changes.

METHODS

: In this retrospective study, included were patients with T2DM (≥18 years old) from Maccabi Healthcare Services in Israel who initiated liraglutide from 2010–2015 and had HbA measurements at treatment initiation and after 24 months. Mean change in HbA and weight from initiation to 24 months after were compared between patients who received regular liraglutide injections for at least 12 months (‘continuers’) with those who discontinued liraglutide before 12 months (‘discontinuers’). Patients who were underwent bariatric surgery within baseline and follow-up period were excluded from the study. Adjustment for potential confounding factors (sex, age, years in diabetes registry, HbA, BMI, and insulin use at treatment initiation) was performed using propensity score 1:1 matching.

RESULTS

: A significant reduction in HbA was seen in continuers compared with discontinuers (after matching n=882, in each group) (0.80% vs. 0.32%, p<0.001), despite the higher use of insulin (70.2% vs. 59.0%, p<0.001) and the higher portion using ≥3 oral antihyperglycemic drugs (within 21-24 months from treatment initiation; 20.6% vs. 6.2%, p<0.001) among discontinuers. Mean weight reduction was higher in continuers than in discontinuers (3.57 kg vs. 1.25 kg; p<0.001) while no significant difference in change in the levels of LDL cholesterol and triglycerides after 24 months from treatment initiation between groups was observed (5.72 vs. 2.83 mg/dl and 10.37 vs 6.89 mg/dl, respectively [both p=Non significant]).

CONCLUSIONS

: The results suggest that persistence with liraglutide is associated with better glycemic and weight control. Further studies are needed to examine whether there is any causal association.