Higher Compliance with Treatment Administration Instructions for Injectable Dulaglutide versus Oral Semaglutide Reported by People with Type 2 Diabetes in Clinical Practice Settings in Spain: The TRU-Experience Study

Silvia Díaz-Cerezo,1 Esther Artime,1 Jennifer Redondo-Antón,1 Natalia Duque,1 Erik Spaepen,2 Miguel Ángel Mangas Cruz,3 Claudia Arnas-Leon,4 Gabriel Olveira,5– 8 Irene Rodríguez Rodríguez,9 María Teresa Julián Alagarda,10 Nuria Valdés,11,12 Agustín Ángel Merchante,13 Lluís Masmiquel,9 Miriam Rubio-de Santos1 1Medical Department. Eli Lilly and Company, Alcobendas, Madrid, Spain; 2HaaPACS GmbH, Schriesheim, Germany; 3Department of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocío, Seville, Spain; 4Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, Spain; 5Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Málaga, Spain; 6Institute of Biomedical Research in Malaga (IBIMA)-Bionand Platform, University of Malaga, Málaga, Spain; 7Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, Málaga, Spain; 8CIBER of Diabetes and Associated Metabolic Diseases, Carlos III Health Institute, Madrid, Spain; 9Department of Endocrinology and Nutrition, Hospital Son Llà tzer, Palma, Spain; 10Department of Endocrinology and Nutrition, Hospital Universitario Germans Trias i Pujol, Badalona, Spain; 11Department of Endocrinology and Nutrition, Hospital Universitario Cruces Biobizkaia, Barakaldo, Spain; 12Endocrinology and Nutrition Department, Universidad del País Vasco/EHU, CIBERDEM, CIBERER, Endo-ERN, Bizkaia, Spain; 13Department of Endocrinology and Nutrition, Hospital General de Castellón, Castellón, SpainCorrespondence: Silvia Díaz-Cerezo, Eli Lilly and Company, Av. de la Industria 30, Madrid, Alcobendas, 28108, Spain, Email [email protected]: This study compared patient-reported compliance with package leaflet administration instructions of two glucagon-like peptide 1 receptor agonists (GLP-1 RAs) for the treatment of type 2 diabetes (T2D): weekly injectable dulaglutide and daily oral semaglutide.Patients and Methods: This was an observational cross-sectional study conducted in Endocrinology Units in Spain. Patients with T2D receiving weekly injectable dulaglutide or daily oral semaglutide at study enrolment who had initiated treatment 3– 12 months before were consecutively recruited during routine visits. Clinical data were extracted from the participants´ medical records. An ad-hoc questionnaire asked how often all and each of the administration instructions specific to each treatment were being followed (eg, timing, steps of intake). Compliance in both groups was calculated using relative and absolute frequencies and matching using the FMA model. The relationship between compliance and sociodemographic/clinical variables was assessed using bivariate analyses. Logistic regression analyses were performed to identify predictors of compliance.Results: A total of 95 participants treated with weekly injectable dulaglutide and 135 participants treated with daily oral semaglutide were evaluated. More participants treated with weekly injectable dulaglutide (96.8%) than participants treated with daily oral semaglutide (90.4%) were compliant with all package leaflet administration instructions. After adjusting for potential between-group imbalances, higher compliance in the weekly injectable dulaglutide group compared with the daily oral semaglutide group was observed (odds ratio=3.2, 95% confidence interval 1.4– 21.3).Conclusion: Compliance with package leaflet administration instructions was significantly higher in patients with T2D receiving weekly injectable dulaglutide compared to those receiving daily oral semaglutide. This type of real-world compliance data can inform strategies to improve patient education and adherence, and physician prescribing practices, with the goal of ultimately leading to better clinical outcomes and quality of life.Keywords: glucagon-like peptide 1 receptor agonists, injectable administration, oral administration, treatment adherence, real world evidence, endocrinology