ECE2021 Audio Eposter Presentations Late Breaking (114 abstracts)
Comparison of the clinical efficacy of Semaglutide between DPP4-inhibitor-naive and DPP4-inhibitor-experienced patients in a real world setting in Spain
Roberto Miguel Sierra Poyatos1, 2, Jersy Jair Cardenas Salas1, 3, Bogdana Luiza Luca1, Nancy María Sanchez Gomez1, Naiara Modroño Mostoles3, Begoña Sánchez Lechuga1, Eva Cruces Vega3, Maria Jesus Silva Rodriguez1, 3, María De La Paz Gómez Montes3, Diego Meneses González1, Teresa Montoya Alvarez3, María de los Angeles Velez Romero1, Alicia Estrella Santos1, Maite Ortega Juaristi1, Maria De Los Angeles Gonzalo Redondo1 & Clotilde Vazquez Martinez1, 2, 3, 4
1Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; 2General Hospital Villalba, Collado Villalba, Spain; 3Hospital Universitario Infanta Elena, Valdemoro, Spain; 4Hospital Universitario Rey Juan Carlos, Móstoles, Spain
Introduction
Glucose and weight control effectiveness in patients with Type 2 diabetes (T2D) in treatment with DPP4 inhibitors (DPP4i) that switch to semaglutide is scarce. We aim to assess it in a real-world setting of DPP4i-experienced patients and compare it to DPP4i-naive patients.
Methods
Patients with T2D that were prescribed Once-Weekly semaglutide in 4 hospitals in Madrid-Spain were identified. Patients with another new glucose-lowering-agent prescription and GLP1-experienced patients were excluded. A total of 250 patients were included. The Changes at 6 months of follow up (Paired T-test, Exact McNemar), and comparison between groups (T-test and Chi2) were analysed. A multiple linear regression model to assess HbA1c change in both DPP4i groups (naive vs experienced) adjusted by age, T2D duration, BMI, baseline-HbA1c, insulin use, SGLT2-inhibitors use and semaglutide dose was perfomed.
Results
Baseline weight and BMI was higher in DPP4i-naive group and HbA1c was higher in DPP4i-experienced group. A higher proportion of patients in the DPP4i-naive group had a baseline-HbA1c <7% compared to DPP4i-experienced. There were no other baseline differences (Table 1). At 6 months of follow up boths groups achieved significant reductions in HbA1C, Glucose, weight, BMI and fat mass, but there were no differences between groups. The proportions of patientes that achieved a HbA1c <7% was higher in the DPP4i-naive group (Table-2). Only patients in the DPP4i-naive group achieved a signifficant reduction in insuline dose. After adjusment, the HbA1c reduction in the DPP4i-experienced group was 0.36% lower than in DPP4-naive (IC95%: 0.14% to 0.59%).
| DPP4i-Naïve n = 153 |
DPP4i-experienced n = 97 |
|
| Age(years) | 60.1±11.0 | 62.0±9.5 |
| Male | 55.6% | 52.6% |
| T2D duration (years) | 9.2±7.4 | 11.13±7.6 |
| Weight (kg)ω | 100.4±18.4 | 94.2±13.7 |
| BMI (kg/m2) ω | 37.0±6.0 | 34.8±4.1 |
| Metformin treatment | 88.2% | 82.5% |
| SGLT2-inhibitors treatment | 40.0% | 32.0% |
| Insulin treatment | 35.3% | 41.2% |
| HbA1c (%) ω | 7.6±1.4 | 8.0±1.3 |
| eGFR(ml/min/1.73 m2) | 85.7±20.1 | 80.2±24.3 |
| HbA1c <7% ω | 43.1% | 22.7% |
| DPP4i-Naive n = 153 |
DPP4i-experienced n = 97 |
|
| Glucose(mg/dl) | -29.0 (-37.4 to –20.7)* | –26.1 (–35.4 to –16.9)* |
| HbA1c (%) | –1.15 (–1.35 to –0.94)* | –0.98 (–1.24 to –0.74)* |
| Weight (kg) | –5.3 (–6.1 to –4.4)* | –4.0 (–5.1 to –3.0)* |
| BMI (kg/m2) | –1.9 (–2.3 to –1.6)* | –1.5 (–1.9 to –1.1)* |
| Fat mass(kg) | –1.54 (–2.84 to –0.24)* n = 54 |
–1.96 (–3.66 to –0.27)* n = 28 |
| Lean mass(kg) | –0.97 (–2.06 to 0.10) n = 49 |
+0.25(–1.31 to 1–83) n = 27 |
| HbA1c <7% ω | 74.5%* | 57.7%* |
| Insuline dose(IU) ω | –11.3 (–18.1 to–4.5)* | –0.9(–5.8 to 4.0) |
| *P<0.05 (6 months vs baseline). ωP <0.05 (DPP4i-Naive vs DPP4i-experienced). |
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Endocrine Abstracts
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