Dosing Patterns of Dulaglutide and Semaglutide in Patients with Type 2 Diabetes Mellitus in France and Italy: A Retrospective Cohort Study.
Level 3 - non-randomized controlled study
Non-randomized retrospective cohort study using administrative prescription data
PubMed 39487881 · doi:10.1007/s12325-024-03002-9
What was done
This retrospective cohort study analyzed prescription data from the IQVIA Longitudinal Prescription Data to evaluate real-world dosing and titration patterns of dulaglutide, subcutaneous semaglutide, and oral semaglutide for type 2 diabetes mellitus in France and Italy. Adults prescribed these GLP-1 receptor agonists between August 1, 2020, and December 31, 2022, were categorized into incident (cohort 1) and prevalent (cohort 2) users and followed for 12 months.
What was found
The study identified 255,571 patients in France and 350,853 in Italy. For dulaglutide, 62% of treatment-naïve patients in France and 49% in Italy initiated at 1.5 mg, and most remained on 1.5 mg at 12 months (France: 66% cohort 1, 88% cohort 2; Italy: 73% cohort 1, 87% cohort 2). For subcutaneous semaglutide, incident users mostly initiated at 0.25 mg (78% France, 61% Italy); at 12 months, 1.0 mg was the most prescribed dose in France (58% cohort 1, 75% cohort 2) and Italy cohort 2 (59%), while Italian cohort 1 patients were mostly on 0.5 mg (57%). For oral semaglutide in Italy, most initiated at 3.0 mg (78% cohort 1, 68% cohort 2), titrating by 12 months predominantly to 7.0 mg in cohort 1 (62%) and 14.0 mg in cohort 2 (48%).
Why it matters
These findings show real-world utilization and dose escalation trajectories of GLP-1 receptor agonists across two major European countries, highlighting how routine clinical maintenance doses often diverge between incident and prevalent cohorts or between countries.
Limits
The abstract reports only prescription records without clinical outcomes (such as HbA1c control or weight change), safety events, adherence, or reasons for non-escalation. Data for oral semaglutide in France were not reported in the abstract.
Cited by
- supports The standard starting dose of Ozempic (semaglutide) is 0.25 mg, escalating to 0.5 mg.