title: Exenatide BID and liraglutide QD treatment patterns among type 2 diabetes patients in Germany.
abstract: OBJECTIVE
  This study evaluated patient and prescriber characteristics, treatment patterns, average daily dose (ADD), and glycemic control of patients initiating glucagon-like peptide 1 (GLP-1) receptor agonists in Germany.
  
  
  METHODS
  The LifeLink™ EMR-EU database was searched to identify patients initiating exenatide twice daily (BID) or liraglutide once daily (QD) during the index period (January 1, 2009-April 4, 2010). Eligible patients had ≥ 180 days pre-index history, ≥ 90 days post-index follow-up, and a pre-index type 2 diabetes diagnosis. Univariate tests were conducted at α=0.05.
  
  
  RESULTS
  Six hundred and ninety-two patients were included (exenatide BID 292, liraglutide QD 400): mean (SD) age 59 (10) years, 59% male. Diabetologists prescribed liraglutide QD to a larger share of patients (65% vs 35% exenatide BID) than non-diabetologists (51% vs 49%). GLP-1 receptor agonist choice was not associated with age (p=0.282), gender (p=0.960), number of pre-index glucose-lowering medications (2.0 [0.9], p=0.159), pre-index HbA1c (8.2 [1.5%], p=0.231) or Charlson Comorbidity Index score (0.45 [0.78], p=0.547). Mean (SD) ADD was 16.7 mcg (9.2, label range 10-20 mcg) for exenatide BID and 1.4 mg (0.7, label range 0.6-1.8 mg) for liraglutide QD. Among patients with post-index HbA1c tests, mean unadjusted values did not differ between cohorts. Exenatide BID patients were more likely than liraglutide QD patients to continue pre-index glucose-lowering medications (67.1% vs 60.3%, p=0.027) or to start concomitant glucose-lowering medications at index (32.2% vs 25.0%, p=0.013); exenatide BID patients were less likely to augment treatment with another drug post-index (15.8% vs 22.5%, p=0.027).
  
  
  CONCLUSIONS
  Results may not be generalizable. Lab measures for clinical outcomes were available only for a sub-set of patients.
  
  
  CONCLUSIONS
  Results suggested that some differences exist between patients initiating exenatide BID or liraglutide QD, with respect to prescribing physician specialty and pre- and post-index treatment patterns. Both GLP-1 receptor agonists showed comparable post-index HbA1c values in a sub-set of patients.
authors.affiliation: Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: Lesley-Ann
authors.initials: LA
authors.lastname: Miller
authors.forename: Chakkarin
authors.initials: C
authors.lastname: Burudpakdee
authors.forename: Anthony
authors.initials: A
authors.lastname: Zagar
authors.forename: Monali
authors.initials: M
authors.lastname: Bhosle
authors.forename: Matthew
authors.initials: M
authors.lastname: Reaney
authors.forename: Vernon F
authors.initials: VF
authors.lastname: Schabert
authors.forename: David
authors.initials: D
authors.lastname: Bruhn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D000077270:Exenatide; D005260:Female; D005858:Germany; D052216:Glucagon-Like Peptide 1 / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D054795:Incretins / Q000627:therapeutic use; D000069450:Liraglutide; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010455:Peptides / Q000008:administration & dosage*; D010818:Practice Patterns, Physicians'; D014688:Venoms / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D054795:Incretins; D010455:Peptides; D014688:Venoms; D000069450:Liraglutide; D052216:Glucagon-Like Peptide 1; D000077270:Exenatide