title: Real-world glycemic outcomes in patients with type 2 diabetes initiating exenatide once weekly and liraglutide once daily: a retrospective cohort study.
abstract: OBJECTIVE
  The glucagon-like peptide-1 receptor agonists exenatide once weekly (QW) and liraglutide once daily (QD) have demonstrated improvements in glycemic outcomes in patients with type 2 diabetes mellitus in randomized clinical trials. However, little is known about their real-world comparative effectiveness. This retrospective cohort study used the Quintiles Electronic Medical Record database to evaluate the 6-month change in glycated hemoglobin (A1C) for patients initiating exenatide QW or liraglutide QD.
  
  
  METHODS
  Patients with type 2 diabetes mellitus prescribed exenatide QW (n=664) or liraglutide QD (n=3,283) between February 1, 2012 and May 31, 2013 were identified. Baseline A1C measures were from 75 days before to 15 days after initiating exenatide QW or liraglutide QD, with follow-up measures documented at 6 months (±45 days). Adjusted linear regression models compared the difference in mean A1C change. A priori defined sensitivity analysis was performed in the subgroup of patients with baseline A1C ≥7.0% and no prescription for insulin during the 12-month pre-index period.
  
  
  RESULTS
  For exenatide QW and liraglutide QD, respectively, mean (SD) age of the main study cohort was 58.01 (10.97) and 58.12 (11.05) years, mean (SD) baseline A1C was 8.4% (1.6) and 8.4% (1.6), and 48.2% and 54.2% of patients were women. In adjusted models, change in A1C did not differ between exenatide QW and liraglutide QD during 6 months of follow-up. Results were consistent in the subgroup analyses.
  
  
  CONCLUSIONS
  In a real-world setting, A1C similarly improves in patients initiating exenatide QW or liraglutide QD.
authors.affiliation: Department of Public Health Sciences, College of Health and Human Services, The University of North Carolina at Charlotte, Charlotte, NC.
authors.forename: William B
authors.initials: WB
authors.lastname: Saunders
authors.affiliation: AstraZeneca, Fort Washington, PA, USA.
authors.forename: Hiep
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: AstraZeneca, Fort Washington, PA, USA.
authors.forename: Iftekhar
authors.initials: I
authors.lastname: Kalsekar
keywords: diabetes; exenatide; outcomes