OBJECTIVES:

To observe the 5-year outcome of drug treatment of patients who initiated AGLP1 in 2012 in order to determine the persistence of AGLP1 therapy and the time to initiation of insulin.

METHODS:

Identification, from SNIIRAM data, of patients 45 years and older initiating an AGLP1 in 2012 without the use of insulin during the two previous years. These patients had to present failure of oral antidiabetic drugs during the 12 months preceding initiation of treatment, which had to be continued over the following 12 months (at least 3 dispensings). Initiation of Xultophy® (fixed combination of insulin and AGLP1) was not considered in this analysis. Patients hospitalised for gestational diabetes, bariatric surgery or end-stage renal disease were also excluded.

Analysis of treatment regimens from 2012 to 2017 was performed on the basis of antidiabetic drug dispensing over the last 4 months of each year.

RESULTS:

Five years after initiation of AGLP1 therapy, more than 50% of patients continued to be reimbursed for AGLP1 (37% were treated with AGLP1 and 27% were treated with AGLP1 + insulin); 16% of patients were treated with insulin without AGLP1; 11% of patients had returned to oral antidiabetic drug therapy and 7% were no longer reimbursed for any form of antidiabetic treatment.

CONCLUSIONS:

The use of AGLP1 following failure of oral antidiabetic drug therapy corresponds to a long-term treatment phase. Prescription of AGLP1 persisted for more than 5 years for the majority of patients: AGLP1 are maintained as the only parenteral treatment or continued in combination with insulin. More than one in ten patients returned to exclusive oral antidiabetic drug therapy.

It could be relevant to investigate treatment discontinuations in more detail.