ASSESSING THE REAL-WORLD EFFICACY OF DULAGLUTIDE IN MALAYSIAN MOH PATIENTS WITH TYPE 2 DIABETES MELLITUS

Abstract

INTRODUCTION/BACKGROUND
An estimated 70% of Type 2 Diabetes Mellitus (T2DM) patients treated in Ministry of Health (MOH) hospitalbased diabetes clinics are still unable to achieve HbA1c targets despite combination glucose-lowering drugs. Moreover, more than 80% of these patients are overweight or obese. In Malaysia, dulaglutide, a once-weekly GLP1RA, was approved in 2018 for use in patients with T2DM. Accessibility to GLP-1RA therapy is much limited in MOH hospitals.

METHODOLOGY
This study aims to assess the glycaemic and weightlowering efficacy of dulaglutide at 6 and 12 months in T2DM patients treated in a real-world clinical setting. We conducted a retrospective study of 69 T2DM patients who initiated dulaglutide in 4 MOH endocrinologist-led hospital-based diabetes clinics (Hospital Putrajaya, Hospital Selayang, Hospital Kuala Lumpur, and Hospital Tuanku Ja’afar). The primary outcome was HbA1c reduction at 6 months of dulaglutide therapy, while the secondary outcomes were HbA1c reduction at 12 months and weight loss at 6 and 12 months.

RESULT
In this study, the patients’ mean baseline age, HbA1c and weight were 54 years old, 8.33% and 91.2 kg, respectively. The mean absolute reduction of HbA1c at 6 months was -0.93% and -0.87% at 12 months. The percentage of patients that achieved ≥2%, 1-2% and 0.5-<1% HbA1c reductions were 16%, 28% and 21% at 6 months, respectively, and 17%, 33% and 11%, at 12 months, respectively. For the secondary outcome analyses, patients experienced a mean weight loss of 3.73 kg at 6 months, and 4.83 kg at 12 months. The percentage of patients that achieved ≥10 kg, 5-10 kg and 1-<5 kg weight reductions at 6 months were 13%, 25%, and 34%, respectively; and at 12 months, 16%, 22% and 41%, respectively.

CONCLUSION
Dulaglutide therapy was shown to be effective in reducing HbA1c and weight at 6 and 12 months of therapy in Malaysian patients with type 2 diabetes currently treated with at least two or more OGLDs, with or without insulin.