OBJECTIVES: The GLP-1 RA class is evolving and expanding. We sought to understand current treatment and dosing patterns of GLP-1 RAs in the real world, namely Germany (DE), France (FR), Belgium (BE), Netherlands (NL) and Italy (IT).

METHODS: Adult T2D patients initiating a GLP-1 RA (liraglutide [LIRA], dulaglutide [DULA], exenatide once-weekly [exQW], exenatide twice-daily [exBID], lixisenatide [LIXI], or albiglutide [ALBI]) between 1/1/2015-12/31/2016 were identified using country-specific IQVIA Longitudinal Prescription Databases (LRx). The therapy initiation date was termed the ‘index date.’ Patients had continuous eligibility/data stability 6 months pre- and ≥12 months post-index and were GLP-1 RA naïve. Persistence on index therapy (until discontinuation/switch to another GLP-1 or another class of non-index antidiabetic therapy) was evaluated descriptively at 1-year post-index (and over available follow-up [data not shown here]). Average daily dose (ADD; and average weekly dose [AWD] for once-weekly GLP-1 RAs) was calculated over the available follow-up while persistent. Results for treatment cohorts with N>100 are included.

RESULTS: The study sample comprised of 35,583 LIRA, 32,867 DULA, 10,696 exQW, 3,459 exBID, 2,179 LIXI and 405 ALBI patients (across countries/therapy cohorts: 34.4-57.2% male, mean age 56.6-62.0 years, mean follow-up 16.2-27.4 months). Proportion persistent at 1-year post-index ranged from: 22.2-57.4% for LIRA, 36.8-67.2% for DULA, 27.9-35.6% for exQW, 11.7-27.5% for exBID, 15.5-27.7% for LIXI, and 29.6% for ALBI. Mean ADD ranged from: 1.44-1.68 mg for LIRA, 13.21-20.43 µg for exBID, and 19.88-20.07 µg for LIXI. Mean AWD ranged from: 1.43-1.53 mg for DULA, 2.03-2.14 mg for exQW, and was 39.46 mg for ALBI.

CONCLUSIONS: Treatment patterns varied among patients initiating different GLP-1 RA therapies. Across countries, the proportion of patients persistent at one year was highest among DULA and LIRA patients and lowest among exBID patients. This analysis shows that ADD/AWD for all GLP-1 RAs was in line with the recommended label.