Real-World Utilization and Effectiveness of Glucagon-Like Peptide-1 Receptor Agonists Dosed Weekly and Daily in Patients with Type 2 Diabetes Mellitus: Results from Retrospective Electronic Medical Records in China

Zhen Ruan,1,* Xianwen Chen,1,* Menghuan Song,1 Ruxu Jia,2 Hang Luo,3 Carolina Oi Lam Ung,1,4,5 Hao Hu1,4,5 1State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, Macau SAR, People’s Republic of China; 2Global Business School for Health, University College London, London, UK; 3Shanghai Palan DataRx Co., Ltd, Shanghai, People’s Republic of China; 4Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau, Macau SAR, People’s Republic of China; 5Centre for Pharmaceutical Regulatory Sciences, University of Macau, Macau, Macau SAR, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hao Hu, University of Macau, Room 1050, E12 Research Building, Macau, Macau SAR, People’s Republic of China, Email haohu@um.edu.moAim: This study aimed to conduct a retrospective observational study in China to investigate the real-world utilization of glucagon-like peptide-1 receptor (GLP-1RA) in China.Methods: Type 2 diabetes mellitus (T2DM) patients were retrieved from the electronic medical records of 18 hospitals from 2016 to 2020. A descriptive analysis detailed patient characteristics and clinical outcomes. Multivariate logistic regression analysed the factors associated with daily and weekly GLP-1RA.Results: Fifteen thousand one hundred and seventy-six individuals were included. At the 6-month follow-up, the overall estimated mean change from baseline in HbA1c was − 1.26± 1.91% (p < 0.001), the “Weekly GLP-1RA” group was − 1.58± 2.03% (p < 0.001), and the “Daily GLP-1RA” group was − 1.25± 1.90% (p < 0.001). At the 12-month follow-up, the overall estimated mean change from baseline in HbA1c was − 0.95± 1.80% (p < 0.001), the “Weekly GLP-1RA” group was − 1.05± 1.93% (p < 0.001), and the “Daily GLP-1RA” group was − 0.95± 1.80% (p < 0.001). At 6 months following GLP-1RA initiation, there were statistically significant improvements in the mean TC, LDL-C, and TG at 6 months or 12 months separately following GLP-1RA initiation. Statistically significant improvements were observed in the mean HDL-C after 6 months. Compared with the baseline (11.92%), the proportion of patients who had an incidence of all hypoglycemia was lower at the 6-month follow-up (9.73%). Patients with dyslipidemia were more likely to use weekly GLP-1RA (OR =1.61, 95% CI: 1.27– 2.06, p < 0.001).Conclusion: In China, weekly GLP-1RA demonstrated better effectiveness compared to the daily GLP-1RA. The results confirmed the efficacy of GLP-1RA in clinical trials.Keywords: type 2 diabetes mellitus, glucagon-like peptide-1 receptor agonist, GLP-1RA, retrospective, China, electronic medical record, real-world