Display options
Share it on

Diabetes Ther. 2013 Dec;4(2):285-308. doi: 10.1007/s13300-013-0037-8. Epub 2013 Sep 10.

Using Exenatide Twice Daily or Insulin in Clinical Practice: Results from CHOICE.

Diabetes therapy : research, treatment and education of diabetes and related disorders

Chantal Mathieu, Claes-Göran Ostenson, Stephan Matthaei, Matthew Reaney, Thure Krarup, Bruno Guerci, Jacek Kiljański, Carole Salaun-Martin, Hélène Sapin, Michael Theodorakis

Affiliations

  1. Department of Endocrinology, UZ Gasthuisberg, 3000, Leuven, Belgium, [email protected].

PMID: 24018835 PMCID: PMC3889314 DOI: 10.1007/s13300-013-0037-8

Abstract

INTRODUCTION: CHOICE (CHanges to treatment and Outcomes in patients with type 2 diabetes initiating InjeCtablE therapy; NCT00635492) assessed, as its primary objective, the time to a 'significant treatment change' (defined within this paper) after patients with type 2 diabetes mellitus initiated their first injectable, glucose-lowering therapy [exenatide twice daily (BID) or insulin] in clinical practice in six European countries and evaluated outcomes during the study.

METHODS: CHOICE was a 24-month, prospective, noninterventional observational study. Patients were invited to participate in CHOICE only after their treating physician had made the clinical decision to initiate first injectable therapy with either exenatide BID or insulin. Clinical data were collected at initiation of first injectable therapy and after approximately 3, 6, 12, 18, and 24 months.

RESULTS: A total of 2,515 patients were recruited; 1,114 patients in the exenatide BID cohort and 1,274 patients in the insulin cohort were eligible for the 24-month analysis. During the study, 42.2% and 36.0% of patients from each cohort, respectively, had a significant treatment change. By 24 months, improved mean glycated hemoglobin (p < 0.001 for both cohorts) and reduced severity of several cardiovascular risk factors were observed in both cohorts; additionally, mean weight was reduced in the exenatide BID cohort (p < 0.001) and increased in the insulin cohort (p < 0.001). Hypoglycemia was reported by 18.4% of the exenatide BID cohort and 36.8% of the insulin cohort; 25.9% of the exenatide BID cohort and 10.0% of the insulin cohort had met the secondary endpoint of glycated hemoglobin <7.0%, no weight gain, and no hypoglycemia.

CONCLUSION: CHOICE provided data on exenatide BID and insulin usage patterns and 24-month outcomes in clinical practice. On average, improved glycemic control and reduced severity of cardiovascular risk factors were observed in both cohorts, and those in the exenatide BID cohort also had mean weight loss.

References

  1. Diabetes Obes Metab. 2012 Jan;14(1):77-82 - PubMed
  2. N Engl J Med. 2011 May 5;364(18):1685-7 - PubMed
  3. Diabetologia. 2009 Oct;52(10):2046-55 - PubMed
  4. Diabetes Ther. 2012 Nov;3(1):6 - PubMed
  5. Health Technol Assess. 2010 Jul;14(36):1-248 - PubMed
  6. Emerg Med J. 2003 Jan;20(1):54-60 - PubMed
  7. Clin Ther. 2007 Nov;29(11):2333-48 - PubMed
  8. Curr Med Res Opin. 2009 Mar;25(3):691-700 - PubMed
  9. Lancet. 2010 Jun 26;375(9733):2234-43 - PubMed
  10. Diabetes Care. 2005 May;28(5):1092-100 - PubMed
  11. BMJ. 2012 Jun 12;344:e3987 - PubMed
  12. J Biopharm Stat. 2007;17(1):1-13; discussion 15-7, 19-21, 23-7 passim - PubMed
  13. Diabetes Care. 2005 May;28(5):1083-91 - PubMed
  14. Clin Ther. 2007;29 Spec No:1284-92 - PubMed
  15. Diabetologia. 2012 Jun;55(6):1577-96 - PubMed
  16. J Manag Care Pharm. 2012 Jan-Feb;18(1 Suppl A):1-22 - PubMed
  17. Diabetes Care. 2004 Nov;27(11):2628-35 - PubMed
  18. Diabetes Obes Metab. 2009 Dec;11(12):1122-30 - PubMed
  19. Diabetologia. 2007 Feb;50(2):259-67 - PubMed
  20. Lancet. 2012 Jun 16;379(9833):2270-8 - PubMed
  21. Curr Med Res Opin. 2011 Mar;27(3):531-40 - PubMed
  22. Ann Intern Med. 2005 Oct 18;143(8):559-69 - PubMed
  23. Diabetes Ther. 2012 Nov;3(1):9 - PubMed
  24. BMJ. 2000 Aug 12;321(7258):405-12 - PubMed
  25. Health Aff (Millwood). 2010 Oct;29(10):1818-25 - PubMed
  26. BMJ. 2012 Jun 12;344:e3974 - PubMed
  27. N Engl J Med. 2007 Oct 25;357(17):1716-30 - PubMed
  28. Curr Med Res Opin. 2011 Dec;27(12):2335-42 - PubMed
  29. N Engl J Med. 2009 Oct 29;361(18):1736-47 - PubMed

Publication Types