Abstract
Patients with type 2 diabetes (T2DM) are at risk of long-term vascular complications. In trials, exenatide once weekly (ExQW), a GLP-1R agonist, improved glycemia, weight, blood pressure (BP), and lipids in patients with T2DM. We simulated potential effects of ExQW on vascular complications, survival, and medical costs over 20 years versus standard therapies. The Archimedes model was used to assess outcomes for ~25,000 virtual patients with T2DM (NHANES 1999-2006 [metformin ± sulfonylureas, age 57 years, body mass index 33 kg/m(2), weight 94 kg, duration T2DM 9 years, hemoglobin A1c [A1C] 8.1%]). The effects of three treatment strategies were modeled and compared to moderate-adherence insulin therapy: advancement to high-adherence insulin at A1C ≥ 8% (treat to target A1C < 7%) and addition of pioglitazone (PIO) or ExQW from simulation start. ExQW effects on A1C, weight, BP, and lipids were modeled from clinical trial data. Costs, inflated to represent 2010 $US, were derived from Medicare data, Drugstore.com, and publications. As ExQW was investigational, we omitted ExQW, PIO, and insulin pharmacy costs. By year 1, ExQW treatment decreased A1C (~1.5%), weight (~2 kg), and systolic BP (~5 mmHg). PIO and high-adherence insulin dec...Continue Reading
References
Aug 10, 1999·Clinical Therapeutics·J B BrownA Bakst
Dec 3, 1999·BMJ : British Medical Journal·D G Altman, P K Andersen
Oct 28, 2003·Diabetes Care·David M Eddy, Leonard Schlessinger
Dec 25, 2003·Diabetes Care·Carol E KoroDonald O Fedder
Dec 24, 2004·Diabetes Care·Joyce A Cramer, Mary Jo Pugh
Aug 17, 2005·Annals of Internal Medicine·David M EddyRichard Kahn
Jul 21, 2006·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Patrick W Sullivan, Vahram Ghushchyan
Dec 29, 2006·Circulation·John B BuseUNKNOWN American Diabetes Association
May 29, 2007·Diabetes Care·Antonio NicolucciGianni Tognoni
Sep 12, 2008·The New England Journal of Medicine·Rury R HolmanH Andrew W Neil
Oct 24, 2008·Diabetes Care·David M NathanUNKNOWN European Association for Study of Diabetes
Dec 17, 2008·Pharmacological Reviews·Wook Kim, Josephine M Egan
Dec 19, 2008·Diabetes Care·Jay S SkylerUNKNOWN American Heart Association
Oct 28, 2009·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Helena W RodbardStanley S Schwartz
Apr 2, 2010·Lancet·Richard KahnNick J Wareham
Jul 9, 2010·Lancet·Michaela DiamantMichael Trautmann
Jan 14, 2011·Diabetes Care·UNKNOWN American Diabetes Association
Feb 11, 2011·The Journal of Clinical Endocrinology and Metabolism·Thomas BlevinsLisa Porter
Mar 26, 2011·Diabetic Medicine : a Journal of the British Diabetic Association·C WyshamK Taylor
Apr 29, 2011·Diabetes Care·Vittorio BaseviNicola Magrini
Citations
Jan 24, 2013·Patient Preference and Adherence·Sheila A Doggrell
May 23, 2015·Expert Review of Cardiovascular Therapy·Marisa B SchauerhamerCarrie McAdam-Marx
Jan 7, 2016·Expert Review of Pharmacoeconomics & Outcomes Research·Tzahit Simon-TuvalDan Greenberg
Jan 1, 2014·Clinical Therapeutics·Namyi GuKyung-Sang Yu
Dec 30, 2014·Diabetes Care·Saul Genuth
Jun 15, 2016·CPT: Pharmacometrics & Systems Pharmacology·K GadkarS Ramanujan
Jun 27, 2013·Journal of Primary Care & Community Health·José A Pagán, Erin K Carlson
Apr 11, 2013·British Journal of Hospital Medicine·Patrick English
Jun 21, 2013·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Gina J RyanDawn D Smiley
Jun 14, 2015·Drugs·Yahiya Y Syed, Paul L McCormack
Aug 8, 2012·Drugs·Lesley J Scott
Jul 22, 2020·BMJ Open Diabetes Research & Care·Bhavani Shankara BagepallyAmmarin Thakkinstian
Mar 12, 2019·PharmacoEconomics·Dongzhe HongLizheng Shi
May 1, 2013·Expert Review of Endocrinology & Metabolism·Courtney Aavang TibbleRobert R Henry
Jan 21, 2021·Cardiovascular Diabetology·Chen-Yi YangShihchen Kuo
Aug 26, 2021·Current Medical Research and Opinion·Piaopiao LiHui Shao