title: Liraglutide improves treatment satisfaction in people with Type 2 diabetes compared with sitagliptin, each as an add on to metformin.
abstract: OBJECTIVE
  Patient-reported outcomes from clinical trials offer insight into the impact of disease on health-related quality of life, including treatment satisfaction. This patient-reported outcomes evaluation was a substudy of a 26-week randomized, open-label trial comparing the once-daily injectable human GLP-1 analogue liraglutide with once-daily oral sitagliptin, both added to metformin. The patient reported outcomes substudy aimed to evaluate treatment satisfaction using the Diabetes Treatment Satisfaction Questionnaire (DTSQ) at baseline and 26 weeks.
  
  
  METHODS
  In the main 26-week randomized, open-label study (n =658), liraglutide, 1.2 or 1.8 mg, injected with a pen, led to greater HbA1c reduction than oral sitagliptin, 100 mg once daily, both added to metformin = 1500 mg daily: mean HbA1c reduction was 1.5, 1.2 and 0.9% (7, 10 and 14 mmol/mol) for liraglutide 1.8 mg, 1.2 mg and sitagliptin, respectively (P < 0.0001 for both liraglutide doses vs. sitagliptin) and liraglutide patients lost more weight (3 vs.1 kg; P < 0.0001). In this patient-reported outcomes substudy (liraglutide 1.8 mg, n = 171; 1.2 mg, n = 164; sitagliptin, n = 170) DTSQ scores were analyzed by ANCOVA with treatment and country as fixed effects and baseline value as covariate.
  
  
  RESULTS
  Overall treatment satisfaction, calculated by adding satisfaction scores for `current treatment', `convenience', `flexibility', `understanding', `recommend', and `continue', improved in all groups at 26 weeks; greater improvement with liraglutide (4.35 and 3.51 vs. 2.96; P = 0.03 for liraglutide 1.8 mg vs. sitagliptin) may reflect greater HbA1c reduction and weight loss. Patients perceived themselves to be hyperglycaemic significantly less frequently with liraglutide 1.8 mg (difference = -0.88; P < 0.0001) and 1.2 mg ( -0.49; P = 0.01). Perceived frequency of hypoglycaemia was similar across all groups.
  
  
  CONCLUSIONS
  Injectable liraglutide may lead to greater treatment satisfaction than oral sitagliptin, potentially by facilitating greater improvement in glycaemic control, weight loss and/ or perception of greater treatment efficacy.
authors.affiliation: University of Leicester, Leicester, UK. melanie.davies@uhl-tr.nhs.uk
authors.forename: M
authors.initials: M
authors.lastname: Davies
authors.forename: R
authors.initials: R
authors.lastname: Pratley
authors.forename: M
authors.initials: M
authors.lastname: Hammer
authors.forename: A B
authors.initials: AB
authors.lastname: Thomsen
authors.forename: R
authors.initials: R
authors.lastname: Cuddihy
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D000069450:Liraglutide; D008297:Male; D008687:Metformin / Q000008:administration & dosage*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011719:Pyrazines / Q000008:administration & dosage*; D011788:Quality of Life / Q000523:psychology; D000068900:Sitagliptin Phosphate; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage*
chemical_list: D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069450:Liraglutide; D008687:Metformin; D011719:Pyrazines; D000068900:Sitagliptin Phosphate; D014230:Triazoles