The real‐world observational prospective study of health outcomes with dulaglutide and liraglutide in patients with type 2 diabetes (TROPHIES): Final, 24‐month analysis of time to first significant treatment change, treatment persistence and clinical outcomes

Abstract

AbstractAimsTo present the final results of the TROPHIES study (The real‐world observational prospective study of health outcomes with dulaglutide and liraglutide in patients with type 2 diabetes).Materials and MethodsThe prospective, real‐world TROPHIES study included patients with type 2 diabetes initiating their first injectable glucose‐lowering medication (GLM), dulaglutide or liraglutide, in France, Germany and Italy. The primary endpoint was the time spent on dulaglutide or liraglutide until a significant treatment change over 24 months. Other endpoints measured persistence with treatment, clinical outcomes (glycated haemoglobin [HbA1c] and weight) and treatment patterns. Kaplan‐Meier estimates of time to first significant treatment change and persistence with treatment were generated. Propensity‐score‐based inverse probability of treatment weighting (IPTW) was used to adjust for baseline imbalances in the comparison between cohorts.ResultsThe 286 of 1014 patients (28.2%) in the dulaglutide cohort and 448 of 991 patients (45.2%) in the liraglutide cohort had a significant treatment change over 24 months. By IPTW analysis, dulaglutide‐initiating patients were less likely to have a significant treatment change (hazard ratio [HR] 0.54, 95% confidence interval [CI] 0.46‐0.63) and more likely to be persistent with treatment (HR 0.69, 95% CI 0.56‐0.86) over 24 months than liraglutide‐initiating patients. Dulaglutide and liraglutide yielded similar HbA1c (−11.80 mmol/mol [1.08%] and −11.91 mmol/mol [1.09%]) and weight (−3.5 kg and −3.3 kg) reductions from baseline to 24 months. Few changes in patterns of treatment with other GLMs were observed in the two cohorts.ConclusionsDulaglutide‐initiating patients had a longer time spent without any significant treatment change and higher persistence than those initiating liraglutide. Treatment with either glucagon‐like peptide‐1 receptor agonist yielded similar and clinically meaningful reductions in HbA1c and body weight.