title: Improved real-world glycaemic outcomes with liraglutide versus other incretin-based therapies in type 2 diabetes.
abstract: OBJECTIVE
  Liraglutide (LIRA) once-daily has provided greater A1C reductions than either exenatide (EXEN) twice-daily or sitagliptin (SITA) once-daily in head-to-head trials. The objective of this analysis is to compare the real-world clinical effectiveness of these agents in the USA.
  
  
  METHODS
  Using the IMS Health (Alexandria, VA, USA) integrated claims database, A1C outcomes in patients aged ≥ 18 years with type 2 diabetes (T2D) who initiated either LIRA, EXEN or SITA (including SITA/metformin) were retrospectively compared. Patients included in the analysis had ≥ 1 prescription for LIRA, EXEN or SITA between January and December 2010 (index period) and persisted with their index treatment regimens for 6 months post-index. Outcomes included changes in A1C from baseline (45 days pre-index through 7 days post-index) to follow-up [6 months post-index (± 45)] and the proportion of patients reaching A1C<7%. Multivariable regression models adjusted for confounding factors (e.g. age, comorbidities, baseline A1C and background antidiabetic therapy).
  
  
  RESULTS
  The predicted change in A1C from baseline was greater for LIRA patients compared with both SITA (-1.08 vs. -0.68%; treatment difference 0.40%, p < 0.0001) and EXEN (-1.08 vs. -0.75%; treatment difference 0.32%, p < 0.001). Predicted A1C goal achievement, derived from the multivariate logistic regression model, was higher with LIRA compared with both SITA [64.4% (95% confidence interval, CI: 63.5-65.3) vs. 49.4% (95% CI: 48.5-50.4); p < 0.0001] and EXEN [64.4% (95% CI: 63.5-65.3) vs. 53.6% (95% CI: 52.6-54.6); p < 0.0001].
  
  
  CONCLUSIONS
  In clinical practice, LIRA was associated with significantly greater reductions in A1C and improved glycaemic goal attainment compared with either EXEN or SITA among adult patients with T2D.
authors.affiliation: Health Economics & Outcomes Research, IMS Health, Alexandria, VA, USA.
authors.forename: W C
authors.initials: WC
authors.lastname: Lee
authors.forename: M
authors.initials: M
authors.lastname: Dekoven
authors.forename: J
authors.initials: J
authors.lastname: Bouchard
authors.forename: M
authors.initials: M
authors.lastname: Massoudi
authors.forename: J
authors.initials: J
authors.lastname: Langer
mesh_terms: D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D000077270:Exenatide; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D054795:Incretins / Q000627:therapeutic use*; D000069450:Liraglutide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000627:therapeutic use*; D012189:Retrospective Studies; D000068900:Sitagliptin Phosphate / Q000627:therapeutic use*; D016896:Treatment Outcome; D014688:Venoms / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D000077270:Exenatide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D054795:Incretins; D000069450:Liraglutide; D010455:Peptides; D000068900:Sitagliptin Phosphate; D014688:Venoms; C517652:hemoglobin A1c protein, human
keywords: clinical effectiveness; comparative effectiveness research; database analysis; liraglutide; type 2 diabetes