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This research was supported by the Fundacio Institut Universitari per a la Recerca a l'Atencio Primaria de Salut Jordi Gol i Gurina (IDIAPJGol), and partially funded and sponsored by GSK Spain.

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Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia

Publicated to:Journal Of Clinical Medicine. 8 (9): 1389- - 2019-09-01 8(9), DOI: 10.3390/jcm8091389

Authors: Franch-Nadal, Josep; Mata-Cases, Manel; Ortega, Emilio; Real, Jordi; Gratacos, Monica; Vlacho, Bogdan; Antoni Valles, Joan; Mauricio, Didac

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Abstract

To assess the clinical characteristics, the prescription pattern of GLP-1 receptor agonists (GLP-1RA) users, and HbA1c and weight change, we retrospectively assessed patients with type 2 diabetes by initiating GLP-1RA as an add-on to the standard of care in Catalonia. The mean change from the baseline in glycated hemoglobin (HbA1c) and weight at 6 and 12 months of therapy was calculated, and we assessed the predictors of the HbA1c reduction of >= 1% and/or the weight reduction of >= 3% as recommended by the Catalan Health Service. In 2854 patients who initiated a GLP-1RA during 2014 and 2015, the overall mean HbA1c values were reduced from the baseline by -0.84% (SD = 1.66) (-9.2 mmol/mol) and lost on average 2.73 kg (SD = 6.2). About 44% percent of patients decreased their HbA1c by >= 1%; 44% decreased their weight by >= 3%; and only 22% met both of them together. The odds of achieving a reduction of >= 1% in initial HbA1c were two-fold higher for patients with higher baseline levels, and the likelihood of a reduction of >= 3% in the initial weight was associated with a higher BMI at the baseline, but they were independent of each other. The composite outcome (target 1% HbA1c reduction and 3% weight loss) to evaluate both the GLP-1RA clinical benefit and treatment withdrawal should be judged from a patient-centered approach.

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