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Observational Study
. 2024 Nov;15(11):1578-1584.
doi: 10.1111/jdi.14265. Epub 2024 Sep 7.

Adherence and treatment discontinuation of oral semaglutide and once-weekly semaglutide injection at 12 month follow-up: Japanese real-world data

Takeshi Horii #  1   2 , Chikako Masudo #  1 , Yui Takayanagi  1 , Yoichi Oikawa  2 , Akira Shimada  2 , Kiyoshi Mihara  1
Affiliations
Observational Study

Adherence and treatment discontinuation of oral semaglutide and once-weekly semaglutide injection at 12 month follow-up: Japanese real-world data

Takeshi Horii et al. J Diabetes Investig. 2024 Nov.

Abstract

Adherence and treatment continuation rates of the glucagon-like peptide-1 receptor agonist (GLP-1RA) semaglutide for both oral (O-SEMA) and subcutaneous injection (SEMA-SC) remain unknown in real-world clinical practice. This retrospective observational study compared the 12 month adherence and treatment discontinuation of O-SEMA and once-weekly SEMA-SC in patients with type 2 diabetes using a real-world claims database. SEMA-SC initiators were 1:1 propensity score-matched to O-SEMA initiators. Non-adherence was defined as <0.8 of the proportion of days covered. SEMA-SC had a significantly higher odds ratio (OR) for non-adherence than O-SEMA (OR: 1.39). The hazard ratio for treatment discontinuation, using O-SEMA as the reference, was 1.45 for SEMA-SC, although the discontinuation rate of O-SEMA was higher during the early stage. O-SEMA initiators showed significantly higher adherence and greater persistence in therapy than SEMA-SC initiators at 12 months, which could lead to earlier initiation of GLP-1RA treatment.

Keywords: Injection; Oral; Semaglutide.

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Conflict of interest statement

A.S. received lecture fees from Astellas Pharma, Inc., Eli Lilly Japan K.K., Novo Nordisk Pharma, Inc., and Sanofi K.K. The authors declare no conflicts of interest.

Approval of the research protocol: The Ethics Board of Musashino University waived the requirement for ethical approval for this study because all available data were completely anonymous with no personal information, which is characteristic of DPC‐based clinical databases. This study was conducted in accordance with the Declaration of Helsinki (revised in Fortaleza, Brazil, October 2013) and the Ethical Guidelines for Medical and Health Research Involving Human Subjects.

Informed consent: All patient data were anonymized and did not contain personal data; therefore, informed consent was not required.

Registry and the registration no. of the study/trial: N/A.

Animal studies: N/A.

Figures

Figure 1
Figure 1
Kaplan–Meier analysis of the incidence of treatment interruption during the observation period in patients with type 2 diabetes receiving oral semaglutide or once‐weekly subcutaneous semaglutide injections. The cumulative incidence of treatment distribution is significantly higher in patients treated with once‐weekly semaglutide injections than in those treated with oral semaglutide (P < 0.001, log‐rank test).
Figure 2
Figure 2
Hazard ratios for treatment interruption in patients with type 2 diabetes using oral semaglutide or once‐weekly semaglutide subcutaneous injection. Forest plots show the hazard ratios (HRs) for treatment interruption in patients with type 2 diabetes using oral semaglutide or once‐weekly semaglutide injection according to baseline clinical characteristics. (a) HR for treatment interruption among all patients with type 2 diabetes using semaglutide. (b) HR for treatment interruption among patients with type 2 diabetes using oral semaglutide. (c) HR for treatment interruption among patients with type 2 diabetes using once‐weekly semaglutide subcutaneous injection. Circles represent the HR, and horizontal bars extend from the lower limit to the upper limit of the 95% confidence interval (CI) of the estimated HR. BMI, body‐mass index; O‐SEMA, oral semaglutide; SEMA‐SC, once‐weekly semaglutide subcutaneous injection; SGLT2is, sodium‐glucose cotransporter 2 inhibitors; α‐GI, alpha‐glucosidase inhibitor.
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