Skip to main content
Top
Published in: Diabetes Therapy 8/2020

Open Access 01-08-2020 | Insulins | Original Research

Persistence with IDegLira in Patients in Clinical Practice: A Nationwide Observational Study in Sweden

Authors: Björn Eliasson, Jan Ekelund, Mervete Miftaraj, Mattis Flyvholm Ranthe, Ann-Charlotte Mårdby, João Diogo Da Rocha Fernandes, Ann-Marie Svensson

Published in: Diabetes Therapy | Issue 8/2020

Login to get access

Abstract

Aims

To explore persistence with insulin degludec/liraglutide (IDegLira) treatment, clinical characteristics and concomitant medications in a large population of patients in clinical practice.

Methods

This was an observational study in patients with type 2 diabetes (n = 2432) who initiated IDegLira between 26 May 2015 and 31 December 2017. Data were obtained from Swedish nationwide registers and linked on an individual level using unique Swedish personal identifiers. Dose calculations were made for patients with ≥ 180 days between the first and last collections of IDegLira prescription. Changes in clinical parameters were evaluated as change from the last observation during 12 months prior to the initiation date until ± 90 days from the last collection of IDegLira.

Results

Pre-index regimens (index date being the date of filling the first prescription of IDegLira) included: multiple daily insulin injections (45.1%); insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) (19.7%); long-acting insulins (11.8%); non-injectable therapy only (11.4%); GLP-1 RA only (9.8%); and no collection of diabetes medication during the 6-month pre-index period (2.3%). The majority of patients (94 and 84%) were persistent with IDegLira at 6 and 12 months, respectively. The most commonly used concomitant medication was metformin (69.4%). Mean daily dose was 33 dose steps. Overall, there was a mean decrease in HbA1c (approx. 10 mmol/mol [1%]) and body weight (− 1.1 kg). Improvements in HbA1c were observed regardless of pre-index treatment.

Conclusion

After 12 months, 84% of patients were persistent on IDegLira, with improved glycaemic control and reductions in body weight.
Appendix
Available only for authorised users
Literature
1.
go back to reference Rawshani A, Rawshani A, Franzen S, et al. Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2018;379:633–44.CrossRef Rawshani A, Rawshani A, Franzen S, et al. Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2018;379:633–44.CrossRef
2.
go back to reference Donnelly LA, Morris AD, Evans JM, DARTS/MEMO collaboration. Adherence to insulin and its association with glycaemic control in patients with type 2 diabetes. Q J Med. 2007;100:345–50.CrossRef Donnelly LA, Morris AD, Evans JM, DARTS/MEMO collaboration. Adherence to insulin and its association with glycaemic control in patients with type 2 diabetes. Q J Med. 2007;100:345–50.CrossRef
3.
go back to reference Cooke CE, Lee HY, Tong YP, Haines ST. Persistence with injectable antidiabetic agents in members with type 2 diabetes in a commercial managed care organization. Curr Med Res Opin. 2010;26:231–8.CrossRef Cooke CE, Lee HY, Tong YP, Haines ST. Persistence with injectable antidiabetic agents in members with type 2 diabetes in a commercial managed care organization. Curr Med Res Opin. 2010;26:231–8.CrossRef
4.
go back to reference Garcia-Perez LE, Alvarez M, Dilla T, Gil-Guillen V, Orozco-Beltran D. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther. 2013;4:175–94.CrossRef Garcia-Perez LE, Alvarez M, Dilla T, Gil-Guillen V, Orozco-Beltran D. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther. 2013;4:175–94.CrossRef
6.
go back to reference Gough SC, Bode B, Woo V, et al. Efficacy and safety of a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with its components given alone: results of a phase 3, open-label, randomised, 26-week, treat-to-target trial in insulin-naive patients with type 2 diabetes. Lancet Diabetes Endocrinol. 2014;2:885–93.CrossRef Gough SC, Bode B, Woo V, et al. Efficacy and safety of a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with its components given alone: results of a phase 3, open-label, randomised, 26-week, treat-to-target trial in insulin-naive patients with type 2 diabetes. Lancet Diabetes Endocrinol. 2014;2:885–93.CrossRef
7.
go back to reference Buse JB, Vilsboll T, Thurman J, et al. Contribution of liraglutide in the fixed-ratio combination of insulin degludec and liraglutide (IDegLira). Diabetes Care. 2014;37:2926–33.CrossRef Buse JB, Vilsboll T, Thurman J, et al. Contribution of liraglutide in the fixed-ratio combination of insulin degludec and liraglutide (IDegLira). Diabetes Care. 2014;37:2926–33.CrossRef
8.
go back to reference Linjawi S, Bode BW, Chaykin LB, et al. The efficacy of IDegLira (insulin degludec/liraglutide combination) in adults with type 2 diabetes inadequately controlled with a GLP-1 receptor agonist and oral therapy: DUAL III randomized clinical trial. Diabetes Ther. 2017;8:101–14.CrossRef Linjawi S, Bode BW, Chaykin LB, et al. The efficacy of IDegLira (insulin degludec/liraglutide combination) in adults with type 2 diabetes inadequately controlled with a GLP-1 receptor agonist and oral therapy: DUAL III randomized clinical trial. Diabetes Ther. 2017;8:101–14.CrossRef
9.
go back to reference Rodbard HW, Bode BW, Harris SB, et al. Safety and efficacy of insulin degludec/liraglutide (IDegLira) added to sulphonylurea alone or to sulphonylurea and metformin in insulin-naive people with type 2 diabetes: the DUAL IV trial. Diabet Med. 2017;34:189–96.CrossRef Rodbard HW, Bode BW, Harris SB, et al. Safety and efficacy of insulin degludec/liraglutide (IDegLira) added to sulphonylurea alone or to sulphonylurea and metformin in insulin-naive people with type 2 diabetes: the DUAL IV trial. Diabet Med. 2017;34:189–96.CrossRef
10.
go back to reference Lingvay I, Pérez Manghi F, Garcia-Hernandez P, et al. Effect of insulin glargine up-titration vs insulin degludec/liraglutide on glycated hemoglobin levels in patients with uncontrolled type 2 diabetes: the DUAL V randomized clinical trial. JAMA. 2016;315:898–907.CrossRef Lingvay I, Pérez Manghi F, Garcia-Hernandez P, et al. Effect of insulin glargine up-titration vs insulin degludec/liraglutide on glycated hemoglobin levels in patients with uncontrolled type 2 diabetes: the DUAL V randomized clinical trial. JAMA. 2016;315:898–907.CrossRef
11.
go back to reference Harris SB, Kocsis G, Prager R, et al. Safety and efficacy of insulin degludec/liraglutide (IDegLira) titrated once weekly (1 Wk) vs. twice weekly (2 Wk) in patients (pts) with T2D uncontrolled on oral antidiabetic drugs: DUAL VI study. Diabetes. 2016;65(Suppl 1):LB23 (Abstract 88-LB). Harris SB, Kocsis G, Prager R, et al. Safety and efficacy of insulin degludec/liraglutide (IDegLira) titrated once weekly (1 Wk) vs. twice weekly (2 Wk) in patients (pts) with T2D uncontrolled on oral antidiabetic drugs: DUAL VI study. Diabetes. 2016;65(Suppl 1):LB23 (Abstract 88-LB).
12.
go back to reference Billings LK, Doshi A, Gouet D, et al. Efficacy and safety of IDegLira versus basal-bolus insulin therapy in patients with type 2 diabetes uncontrolled on metformin and basal insulin: the DUAL VII randomized clinical trial. Diabetes Care. 2018;41:1009–166.CrossRef Billings LK, Doshi A, Gouet D, et al. Efficacy and safety of IDegLira versus basal-bolus insulin therapy in patients with type 2 diabetes uncontrolled on metformin and basal insulin: the DUAL VII randomized clinical trial. Diabetes Care. 2018;41:1009–166.CrossRef
13.
go back to reference Aroda VR, Gonzalez-Galvez G, Gron R, et al. Durability of insulin degludec plus liraglutide versus insulin glargine U100 as initial injectable therapy in type 2 diabetes (DUAL VIII): a multicentre, open-label, phase 3b, randomised controlled trial. Lancet Diabetes Endocrinol. 2019;7:596–605.CrossRef Aroda VR, Gonzalez-Galvez G, Gron R, et al. Durability of insulin degludec plus liraglutide versus insulin glargine U100 as initial injectable therapy in type 2 diabetes (DUAL VIII): a multicentre, open-label, phase 3b, randomised controlled trial. Lancet Diabetes Endocrinol. 2019;7:596–605.CrossRef
14.
go back to reference Philis-Tsimikas A, Billings LK, Busch R, et al. Superior efficacy of insulin degludec/liraglutide versus insulin glargine U100 as add-on to sodium-glucose co-transporter-2 inhibitor therapy: a randomized clinical trial in patients with uncontrolled type 2 diabetes. Diabetes Obes Metab. 2019;21:1399–408.CrossRef Philis-Tsimikas A, Billings LK, Busch R, et al. Superior efficacy of insulin degludec/liraglutide versus insulin glargine U100 as add-on to sodium-glucose co-transporter-2 inhibitor therapy: a randomized clinical trial in patients with uncontrolled type 2 diabetes. Diabetes Obes Metab. 2019;21:1399–408.CrossRef
15.
go back to reference Marso SP, McGuire DK, Zinman B, et al. Efficacy and safety of degludec versus glargine in type 2 diabetes. N Engl J Med. 2017;377:723–32.CrossRef Marso SP, McGuire DK, Zinman B, et al. Efficacy and safety of degludec versus glargine in type 2 diabetes. N Engl J Med. 2017;377:723–32.CrossRef
16.
go back to reference Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311–22.CrossRef Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311–22.CrossRef
17.
go back to reference Price H, Bluher M, Prager R, Phan TM, Thorsted BL, Schultes B. Use and effectiveness of a fixed-ratio combination of insulin degludec/liraglutide (IDegLira) in a real-world population with type 2 diabetes: results from a European, multicentre, retrospective chart review study. Diabetes Obes Metab. 2018;20:954–62.CrossRef Price H, Bluher M, Prager R, Phan TM, Thorsted BL, Schultes B. Use and effectiveness of a fixed-ratio combination of insulin degludec/liraglutide (IDegLira) in a real-world population with type 2 diabetes: results from a European, multicentre, retrospective chart review study. Diabetes Obes Metab. 2018;20:954–62.CrossRef
18.
go back to reference Sofra D. Glycemic control in a real-life setting in patients with type 2 diabetes treated with IDegLira at a single Swiss center. Diabetes Ther. 2017;8:377–84.CrossRef Sofra D. Glycemic control in a real-life setting in patients with type 2 diabetes treated with IDegLira at a single Swiss center. Diabetes Ther. 2017;8:377–84.CrossRef
19.
go back to reference Ludvigsson JF, Svedberg P, Olen O, Bruze G, Neovius M. The longitudinal integrated database for health insurance and labour market studies (LISA) and its use in medical research. Eur J Epidemiol. 2019;34:423–37.CrossRef Ludvigsson JF, Svedberg P, Olen O, Bruze G, Neovius M. The longitudinal integrated database for health insurance and labour market studies (LISA) and its use in medical research. Eur J Epidemiol. 2019;34:423–37.CrossRef
20.
go back to reference Eliasson B, Gudbjornsdottir S. Diabetes care—improvement through measurement. Diabetes Res Clin Pract. 2014;106(Suppl 2):S291–S294294.CrossRef Eliasson B, Gudbjornsdottir S. Diabetes care—improvement through measurement. Diabetes Res Clin Pract. 2014;106(Suppl 2):S291–S294294.CrossRef
21.
go back to reference World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4.CrossRef World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4.CrossRef
22.
go back to reference Roussel R, Charbonnel B, Behar M, Gourmelen J, Emery C, Detournay B. Persistence with insulin therapy in patients with type 2 diabetes in France: an insurance claims study. Diabetes Ther. 2016;7:537–49.CrossRef Roussel R, Charbonnel B, Behar M, Gourmelen J, Emery C, Detournay B. Persistence with insulin therapy in patients with type 2 diabetes in France: an insurance claims study. Diabetes Ther. 2016;7:537–49.CrossRef
23.
go back to reference Wang L, Wei W, Miao R, Xie L, Baser O. Real-world outcomes of US employees with type 2 diabetes mellitus treated with insulin glargine or neutral protamine Hagedorn insulin: a comparative retrospective database study. BMJ Open. 2013;3:e002348.CrossRef Wang L, Wei W, Miao R, Xie L, Baser O. Real-world outcomes of US employees with type 2 diabetes mellitus treated with insulin glargine or neutral protamine Hagedorn insulin: a comparative retrospective database study. BMJ Open. 2013;3:e002348.CrossRef
24.
go back to reference Rodbard HW, Cariou B, Zinman B, et al. Comparison of insulin degludec with insulin glargine in insulin-naive subjects with Type 2 diabetes: a 2-year randomized, treat-to-target trial. Diabet Med. 2013;30:1298–304.CrossRef Rodbard HW, Cariou B, Zinman B, et al. Comparison of insulin degludec with insulin glargine in insulin-naive subjects with Type 2 diabetes: a 2-year randomized, treat-to-target trial. Diabet Med. 2013;30:1298–304.CrossRef
25.
go back to reference Lind M, Matsson PO, Linder R, et al. Clinical effectiveness of liraglutide vs sitagliptin on glycemic control and body weight in patients with type 2 diabetes: a retrospective assessment in Sweden. Diabetes Ther. 2016;7:321–33.CrossRef Lind M, Matsson PO, Linder R, et al. Clinical effectiveness of liraglutide vs sitagliptin on glycemic control and body weight in patients with type 2 diabetes: a retrospective assessment in Sweden. Diabetes Ther. 2016;7:321–33.CrossRef
26.
go back to reference Bonafede MMK, Kalsekar A, Pawaskar M, et al. A retrospective database analysis of insulin use patterns in insulin-naïve patients with type 2 diabetes initiating basal insulin or mixtures. Patient Prefer Adherence. 2010;4:147–56.CrossRef Bonafede MMK, Kalsekar A, Pawaskar M, et al. A retrospective database analysis of insulin use patterns in insulin-naïve patients with type 2 diabetes initiating basal insulin or mixtures. Patient Prefer Adherence. 2010;4:147–56.CrossRef
Metadata
Title
Persistence with IDegLira in Patients in Clinical Practice: A Nationwide Observational Study in Sweden
Authors
Björn Eliasson
Jan Ekelund
Mervete Miftaraj
Mattis Flyvholm Ranthe
Ann-Charlotte Mårdby
João Diogo Da Rocha Fernandes
Ann-Marie Svensson
Publication date
01-08-2020
Publisher
Springer Healthcare
Published in
Diabetes Therapy / Issue 8/2020
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI
https://doi.org/10.1007/s13300-020-00872-4

Other articles of this Issue 8/2020

Diabetes Therapy 8/2020 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.