Background According to the latest NICE Guidelines for the management of type 2 diabetes, glucagon-like peptide 1 analogues (GLP-1) are indicated after failure of other therapies and should be considered ineffective in the absence of a metabolic response after 6 months of treatment.
Purpose To analyse the adequacy and effectiveness of liraglutide use in type 2 diabetes management in clinical practice.
Material and methods A retrospective study was conducted in diabetic patients who started treatment with liraglutide in 2013 in a health area comprising 450 000 inhabitants. Prescription data were obtained from the official prescription database (Microstrategy). Clinical data for assessing adequacy and effectiveness were obtained from medical records. It was considered appropriate to use liraglutide when basal HbA1c was ≥7.5%. Treatment was considered effective when HbA1c reduction was ≥1% 6 months after the start of therapy. The absence of HbA1c data was considered an inadequacy criterion. Effectiveness was evaluated only for those patients with analytical results. The percentage of patients in which the treatment was adequate, percentage of patients in which the treatment was effective and percentage of patients in which the treatment was withdrawn following lack of effectiveness were determined.
Results During 2013, 82 patients began treatment with liraglutide. It was a suitable treatment in 55% of patients (n=45). Lack of analytical results for HbA1c led to the inadequacy criterion in 25 patients. Only 51 patients had analytical data to assess effectiveness. 45% (n=23) of patients had a reduction ≥1%, with a mean HbA1c reduction of 0.85% (95% CI 0.31 to 1.37). Treatment was continued for a year later despite being ineffective in 22 patients (79%).
Conclusion Liraglutide use did not meet the criteria for adequacy for the indication in half of the patients. In more than half of the patients, liraglutide was ineffective in the metabolic control of type 2 diabetes. Despite the lack of effectiveness, liraglutide was continued in most patients.
No conflict of interest
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