Real-world clinical outcomes following treatment intensification with GLP-1 RA, OADs or insulin in patients with type 2 diabetes on two oral agents (PATHWAY 2-OADs).

Most patients with type 2 diabetes require sequential addition of glucose-lowering agents to maintain long-term glycemic control. In this retrospective, observational study, we compared intensification with a glucagon-like peptide-1 receptor agonist (GLP-1 RA), oral antidiabetic drugs (OADs), and insulin in patients receiving two OADs, using US electronic health records and claims data. For inclusion, patients in the IBM MarketScan Explorys database were required to have claims for two different OADs in the 180-day baseline period and ≥1 claim for a different OAD/GLP-1 RA/insulin at index date (treatment intensification). Changes in glycated hemoglobin (HbA Significantly more patients intensifying with a GLP-1 RA achieved HbA In propensity score-matched cohorts, GLP-1 RAs demonstrated significant benefits for both glycemic control and weight management over additional OAD(s) or insulin, respectively, indicating that they may represent the optimal choice at these points in the treatment pathway.

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Competing interests: CD has performed consultancy for AstraZeneca, Bayer AG and Novo Nordisk A/S. ARK and MLW are employees of, and shareholders in, Novo Nordisk A/S. KKM is an employee of Novo Nordisk Global Service Centre India, which is part of Novo Nordisk A/S. IL has performed consultancy for AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Eli Lilly and Company, Intarcia Therapeutics, Janssen Pharmaceuticals, MannKind Corporation, Novo Nordisk A/S, Sanofi, TARGET PharmaSolutions and Valeritas.