Liraglutide shows 98% lower switching odds compared to subcutaneous semaglutide in Polish GLP-1 RA users
Background
Effective management of Type 2 Diabetes and obesity often involves long-term pharmacotherapy, with GLP-1 receptor agonists (GLP-1 RAs) being a cornerstone due to their robust glycemic control and weight loss benefits. However, real-world adherence and persistence with these medications can vary, influenced by factors like side effects, convenience, and perceived efficacy. Understanding patient switching patterns between different GLP-1 RAs is crucial for optimizing treatment strategies, informing prescribing decisions, and improving long-term patient outcomes in clinical practice.
Study Design
Researchers conducted a retrospective analysis of GLP-1 RA prescription records from the LUX MED network in Poland, spanning 2018-2025. The study included n=42,423 patients with more than one prescription. Switching was defined as any change in the prescribed agent between consecutive prescriptions. The primary analysis utilized a transition-level discrete-time hazard model, where each prescription-to-prescription interval contributed an observation, with switching as the outcome. Current therapy contrasts were reported relative to subcutaneous semaglutide as the reference.
Results
Overall, 29.7% of patients switched their GLP-1 RA at least once, and 14.3% switched two or more times. The transition-level analysis involved 12,620 patients contributing 27,095 transitions. After adjusting for switching opportunity and calendar-time dynamics, significant differences emerged in switching odds between agents. Liraglutide was associated with substantially lower odds of switching compared to subcutaneous semaglutide (OR, 0.02; 95% CI, 0.01-0.03), indicating a 98% reduction in switching likelihood. In contrast, oral semaglutide (OR, 1.30; 95% CI, 0.78-2.17) and dulaglutide (OR, 1.70; 95% CI, 0.95-3.04) did not show statistically significant differences in switching odds when compared to subcutaneous semaglutide. Temporal analyses also revealed peaks consistent with episodic substitution and accelerated tirzepatide uptake following its market entry, highlighting dynamic prescribing trends.
Key Findings
- 29.7% of patients switched their GLP-1 RA at least once between 2018-2025.
- Liraglutide was associated with 98% lower odds of switching compared to subcutaneous semaglutide (OR, 0.02; 95% CI, 0.01-0.03).
- Oral semaglutide (OR, 1.30) and dulaglutide (OR, 1.70) did not significantly differ from subcutaneous semaglutide in switching odds.
- Temporal analyses showed peaks consistent with episodic substitution and accelerated tirzepatide uptake after market entry.
Why It Matters
Real-world data on GLP-1 RA switching provides crucial insights for optimizing patient management and adherence. Liraglutide's significantly lower switching rate suggests it may offer greater long-term persistence for some patients compared to subcutaneous semaglutide, which could influence initial prescribing decisions. This finding is particularly relevant for clinicians and patients prioritizing treatment continuity. Understanding these patterns can help healthcare providers anticipate potential changes in therapy and counsel patients more effectively on the expected course of their GLP-1 RA treatment, potentially improving overall therapeutic success and resource allocation within healthcare systems.