Effectiveness and Tolerability of Therapy With Once-Weekly Exenatide Versus Basal Insulin Among Injectable-Naive Patients With Type 2 Diabetes in a Real-World Setting in the United States

Diabetes Spectrum : a Publication of the American Diabetes Association
Anita M LoughlinJohn D Seeger

Abstract

A propensity-matched cohort study compared injectable-naive patients with type 2 diabetes initiating exenatide once weekly (EQW) or basal insulin (BI), from 2012 through 2015, within a U.S. electronic health record database. A1C and weight were obtained as observed or multiply imputed values at baseline and quarterly for 1 year (Q1-Q4). Hypoglycemia and gastrointestinal symptoms were identified using diagnostic codes and clinical notes. EQW (n = 2,008) and BI (n = 4,016) cohorts were comparable at baseline (mean A1C and weight: EQW, 8.3% and 107.5 kg, respectively; BI, 8.5% and 107.9 kg, respectively). A1C declined in Q2: -0.69 and -0.50 percentage points for EQW and BI, respectively, with little further change in year 1. The EQW cohort lost 0.9 kg in Q1 and 1.9 kg by the end of the year; no weight change was observed in the BI cohort. Among EQW and BI cohorts, 25.9% and 14.3% achieved both glycemic control and weight loss, respectively. In the EQW and BI cohorts, the incidence of hypoglycemia per 1,000 person-years was 52.5 and 65.7, respectively. The incidence of nausea was greater among EQW relative to BI initiators (relative rate 1.18). EQW offers an advantage compared to BI in achieving glycemic control and weight loss and...Continue Reading

References

Jan 15, 2005·Pharmacoepidemiology and Drug Safety·John D SeegerAlexander M Walker
May 8, 2007·Primary Care·William F Miser
Sep 18, 2007·Pharmacoepidemiology and Drug Safety·UNKNOWN ISPE
Apr 3, 2008·BMC Endocrine Disorders·Adit A GindeCarlos A Camargo
Jan 29, 2010·American Journal of Epidemiology·Katherine J Lee, John B Carlin
Jun 16, 2012·Journal of Diabetes and Its Complications·Setareh A WilliamsVivian Fonseca
Apr 16, 2014·The Lancet. Diabetes & Endocrinology·Michaela DiamantMichael E Trautmann

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