Cargando…

FRI639 Effect Of Early Initiation Of GLP-1 RAs On Weight Reduction Among People With Type 2 Diabetes

Disclosure: C. Chinthammit: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. R. Mody: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. D. Liu: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company....

Descripción completa

Detalles Bibliográficos
Autores principales: Chinthammit, Chanadda, Mody, Reema, Liu, Dongju, Benneyworth, Brian D, Vallarino, Carlos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10555450/
http://dx.doi.org/10.1210/jendso/bvad114.858
_version_ 1785116660598833152
author Chinthammit, Chanadda
Mody, Reema
Liu, Dongju
Benneyworth, Brian D
Vallarino, Carlos
author_facet Chinthammit, Chanadda
Mody, Reema
Liu, Dongju
Benneyworth, Brian D
Vallarino, Carlos
author_sort Chinthammit, Chanadda
collection PubMed
description Disclosure: C. Chinthammit: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. R. Mody: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. D. Liu: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. B.D. Benneyworth: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. C. Vallarino: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. Early initiation of glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy is associated with improved glycemic outcomes among people with type 2 diabetes (T2D). However, there is limited real-world evidence suggesting a similar impact on weight reduction. This study examined the relationship between timing of initiation of a GLP-1 RA and magnitude of weight reduction. This retrospective cohort study used data from the Optum(®) de-identified Market Clarity database from April 1, 2014, to March 31, 2020. Adults with T2D who initiated GLP-1 RA treatment during the index period, April 1, 2016 - March 31, 2019, were included. Date of first prescription was defined as index date. Patients were required to have continuous enrollment ≥2 years pre-index and 1-year post-index; have ≥1 weight and BMI values during the 6-month baseline and 1-year post-index periods; baseline BMI ≥25 kg/m(2), and ≥1 pre-index oral antihyperglycemic drug (OAD) claim. Timing of GLP-1 RA initiation was proxied by the number of classes of OADs (1 OAD, 2 OADs, 3+ OADs) prescribed in the pre-index period, with fewer OADs indicating initiation of GLP-1 RA earlier in disease progression. Outcomes included weight change from baseline to 6 and 12 months of follow-up and proportion of patients achieving ≥5% weight reduction after GLP-1 RA initiation. In order to control for confounding, multivariable analyses (MVA) used weights based on propensity scores to examine the relationship between timing of GLP-1 RA initiation and post-index weight outcomes. Of the 4,194 patients evaluated, 1,317 (31.4%), 1,480 (35.3%), and 1,397 (33.3%) were classified into the 1 OAD, 2 OAD, and 3+ OAD cohorts, respectively. Baseline characteristics were fairly uniform across the three cohorts, but the 1 OAD cohort had more females (59.5%) than 2 OAD (51.1%) and 3+ OAD (44.7%), and a higher mean baseline BMI (1 OAD: 38.7 kg/m(2); 2 OAD: 37.4 kg/m(2); 3+ OAD: 36.4 kg/m(2); p<0.0001). The 1 OAD cohort experienced a larger magnitude of weight reduction from baseline to 6 months (-3.0 kg) and 12 months (-3.1 kg) of follow-up vs 2 OAD (-2.4 kg and -2.7 kg) and 3+ OAD (-2.3 kg and -2.4 kg). The 1 OAD cohort had the largest proportion of patients who achieved ≥5% weight reduction at 6 months (24.9%) and 12 months of follow-up (25.5%) vs 2 OAD (19.7% and 22.1%) and 3+ OAD (21.4% and 20.6%). MVA showed that earlier GLP-1 RA initiation (1 OAD) was associated with greater weight reduction at 6 months (p=0.008) and 12 months (p=0.012) of follow-up compared to later initiation (3+ OAD). No significant differences in weight change were observed between the 2 OAD and 3+ OAD cohorts. This study showed that earlier initiators (1 OAD) of a GLP-1 RA experienced a larger magnitude of weight reduction than later initiators (3+ OADs). The research underscores the importance of further exploring the potential impact of early T2D treatment on weight reduction. Presentation: Friday, June 16, 2023
format Online
Article
Text
id pubmed-10555450
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-105554502023-10-06 FRI639 Effect Of Early Initiation Of GLP-1 RAs On Weight Reduction Among People With Type 2 Diabetes Chinthammit, Chanadda Mody, Reema Liu, Dongju Benneyworth, Brian D Vallarino, Carlos J Endocr Soc Diabetes And Glucose Metabolism Disclosure: C. Chinthammit: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. R. Mody: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. D. Liu: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. B.D. Benneyworth: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. C. Vallarino: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. Early initiation of glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy is associated with improved glycemic outcomes among people with type 2 diabetes (T2D). However, there is limited real-world evidence suggesting a similar impact on weight reduction. This study examined the relationship between timing of initiation of a GLP-1 RA and magnitude of weight reduction. This retrospective cohort study used data from the Optum(®) de-identified Market Clarity database from April 1, 2014, to March 31, 2020. Adults with T2D who initiated GLP-1 RA treatment during the index period, April 1, 2016 - March 31, 2019, were included. Date of first prescription was defined as index date. Patients were required to have continuous enrollment ≥2 years pre-index and 1-year post-index; have ≥1 weight and BMI values during the 6-month baseline and 1-year post-index periods; baseline BMI ≥25 kg/m(2), and ≥1 pre-index oral antihyperglycemic drug (OAD) claim. Timing of GLP-1 RA initiation was proxied by the number of classes of OADs (1 OAD, 2 OADs, 3+ OADs) prescribed in the pre-index period, with fewer OADs indicating initiation of GLP-1 RA earlier in disease progression. Outcomes included weight change from baseline to 6 and 12 months of follow-up and proportion of patients achieving ≥5% weight reduction after GLP-1 RA initiation. In order to control for confounding, multivariable analyses (MVA) used weights based on propensity scores to examine the relationship between timing of GLP-1 RA initiation and post-index weight outcomes. Of the 4,194 patients evaluated, 1,317 (31.4%), 1,480 (35.3%), and 1,397 (33.3%) were classified into the 1 OAD, 2 OAD, and 3+ OAD cohorts, respectively. Baseline characteristics were fairly uniform across the three cohorts, but the 1 OAD cohort had more females (59.5%) than 2 OAD (51.1%) and 3+ OAD (44.7%), and a higher mean baseline BMI (1 OAD: 38.7 kg/m(2); 2 OAD: 37.4 kg/m(2); 3+ OAD: 36.4 kg/m(2); p<0.0001). The 1 OAD cohort experienced a larger magnitude of weight reduction from baseline to 6 months (-3.0 kg) and 12 months (-3.1 kg) of follow-up vs 2 OAD (-2.4 kg and -2.7 kg) and 3+ OAD (-2.3 kg and -2.4 kg). The 1 OAD cohort had the largest proportion of patients who achieved ≥5% weight reduction at 6 months (24.9%) and 12 months of follow-up (25.5%) vs 2 OAD (19.7% and 22.1%) and 3+ OAD (21.4% and 20.6%). MVA showed that earlier GLP-1 RA initiation (1 OAD) was associated with greater weight reduction at 6 months (p=0.008) and 12 months (p=0.012) of follow-up compared to later initiation (3+ OAD). No significant differences in weight change were observed between the 2 OAD and 3+ OAD cohorts. This study showed that earlier initiators (1 OAD) of a GLP-1 RA experienced a larger magnitude of weight reduction than later initiators (3+ OADs). The research underscores the importance of further exploring the potential impact of early T2D treatment on weight reduction. Presentation: Friday, June 16, 2023 Oxford University Press 2023-10-05 /pmc/articles/PMC10555450/ http://dx.doi.org/10.1210/jendso/bvad114.858 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Diabetes And Glucose Metabolism
Chinthammit, Chanadda
Mody, Reema
Liu, Dongju
Benneyworth, Brian D
Vallarino, Carlos
FRI639 Effect Of Early Initiation Of GLP-1 RAs On Weight Reduction Among People With Type 2 Diabetes
title FRI639 Effect Of Early Initiation Of GLP-1 RAs On Weight Reduction Among People With Type 2 Diabetes
title_full FRI639 Effect Of Early Initiation Of GLP-1 RAs On Weight Reduction Among People With Type 2 Diabetes
title_fullStr FRI639 Effect Of Early Initiation Of GLP-1 RAs On Weight Reduction Among People With Type 2 Diabetes
title_full_unstemmed FRI639 Effect Of Early Initiation Of GLP-1 RAs On Weight Reduction Among People With Type 2 Diabetes
title_short FRI639 Effect Of Early Initiation Of GLP-1 RAs On Weight Reduction Among People With Type 2 Diabetes
title_sort fri639 effect of early initiation of glp-1 ras on weight reduction among people with type 2 diabetes
topic Diabetes And Glucose Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10555450/
http://dx.doi.org/10.1210/jendso/bvad114.858
work_keys_str_mv AT chinthammitchanadda fri639effectofearlyinitiationofglp1rasonweightreductionamongpeoplewithtype2diabetes
AT modyreema fri639effectofearlyinitiationofglp1rasonweightreductionamongpeoplewithtype2diabetes
AT liudongju fri639effectofearlyinitiationofglp1rasonweightreductionamongpeoplewithtype2diabetes
AT benneyworthbriand fri639effectofearlyinitiationofglp1rasonweightreductionamongpeoplewithtype2diabetes
AT vallarinocarlos fri639effectofearlyinitiationofglp1rasonweightreductionamongpeoplewithtype2diabetes