Characterization of Interchanging Incretin Analogs in Clinical Practice: A Descriptive Report
Authors' conclusion
This characterization report demonstrates an effective approach to addressing incretin analog interchanges. A high level of tolerability is evident with the defined interchange process. Future studies should continue to confirm effective and safe interchanges of incretin analogs from outcomes and tolerability reports.
Study context
- Population
- Adult outpatients of a participating family medicine or endocrinology clinic at a major academic medical center, January 1–November 30, 2022, with an initiated recommended incretin analog interchange and a tolerability assessment
- Participants
- 156 outpatients
- Outcome
- Tolerability of incretin analog interchanges to equipotent or higher strengths
Methodological detailssingle academic medical center, descriptive
- Single academic medical center
- Descriptive
Main finding
As reported in the abstract
Patients who tolerated the interchange
96%
Did not tolerate interchange
7 patients
Observational data: associations, not effects.
Further findings
Dose change at interchange
- Dose escalation
- 58%
- Equipotent dose
- 41%
- Dose decrease considered
- 1 patient
Prior authorization required for new therapy
- Prior authorizations required
- 74%
Most common interchanges (dulaglutide 4.5 mg to tirzepatide 7.5 mg, dulaglutide 4.5 mg to tirzepatide 10 mg, dulaglutide 3 mg to tirzepatide 7.5 mg)
- Share of total population
- 37.3%
- Tolerability
- 93%
Time to maximum dose
- Estimated median reduction in time to maximum dose
- 3 months
Interruption of therapy (missed incretin analog dose)
- Patients with therapy interruption
- 0
Safety
Intolerance of interchange
- Did not tolerate interchange
- 7 patients
- Gastrointestinal effects
- 5
- Injection site reactions
- 2
Original publication
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