{
  "abstract": "Background and Objectives In Italy, the prescription of Glucagon-Like Peptide-1 Receptor Analogues (GLP1-RA) reimbursed by the National Health Service (NHS) is regulated by AIFA Note 100, which authorises their use in adult patients with type 2 diabetes mellitus (T2DM) with inadequate glycaemic control (HbA1c >7.0%).In Sicily, GLP1-RA for this indication are dispensed exclusively through the distribution ‘per conto’ (DPC) channel.This analysis aims to evaluate one-year persistence to treatment with GLP1-RA in patients with T2DM resident in Sicily and to identify the main predictive factors associated with treatment discontinuation.Materials and Methods A retrospective study was conducted using dispensing data collected through the DPC channel for the period 2021–2024.Patients with a new prescription of GLP1-RA were selected. New users were defined as individuals who received a first dispensing at least 120 days after the start of the observation period, in order to exclude patients already on treatment and ensure the inclusion exclusively of new users. A minimum follow-up of 12 months from the date of first dispensing was required.Persistence at 12 months, defined as the time in days between the first and last dispensing (including the days covered by the final supply) in the absence of a time gap greater than 60 days, was analysed using Kaplan-Meier curves. Statistical analyses included the log-rank test and Cox regression models adjusted for active substance, age, and gender.Results A total of 12,468 patients were included, with 3,417 discontinuation events observed at one year. Persistence differed significantly across treatments (log-rank p<0.0001), with the highest values recorded for dulaglutide (78.7%), followed by semaglutide (69.6%), exenatide (49.6%), and liraglutide (39.6%).Cox regression analysis (reference: dulaglutide) showed a progressively increasing risk of discontinuation for semaglutide (HR=1.56; p<0.001), exenatide (HR=3.05; p<0.001), and liraglutide (HR=3.65; p<0.001).Gender had no significant impact on persistence (p=0.72). Conversely, age proved to be a determining factor: patients aged 45-64 years (HR=0.62) and 65-79 years (HR=0.72) showed higher persistence compared with those aged ≥80 years (p<0.001).Conclusions This real-world analysis highlights important differences in persistence among GLP1-RA, with a favourable profile for dulaglutide and greater critical issues for liraglutide and exenatide.The impact of advanced age suggests the need to adopt a more personalised therapeutic approach, favouring medicines with greater continuity of use and including intensified monitoring strategies in elderly patients or in those treated with active substances associated with a higher risk of discontinuation.",
  "authors": [
    {
      "affiliations": [
        "Scuola di Specializzazione in Farmacia Ospedaliera (SSFO) - Universit degli Studi di Palermo"
      ],
      "name": "Tardibuono Vincenza Adriana"
    },
    {
      "affiliations": [
        "Scuola di Specializzazione in Farmacia Ospedaliera (SSFO) - Universit degli Studi di Palermo"
      ],
      "name": "Santonocito Marco"
    },
    {
      "affiliations": [
        "Dipartimento Interaziendale Farmaceutico - ASP Palermo"
      ],
      "name": "Ruvolo Giuseppina"
    },
    {
      "affiliations": [
        "Dipartimento Interaziendale Farmaceutico - ASP Palermo"
      ],
      "name": "D’amico Delia"
    },
    {
      "affiliations": [
        "Dipartimento Interaziendale Farmaceutico - ASP Palermo"
      ],
      "name": "Pastorello Maurizio"
    }
  ],
  "title": "NP-009 Discontinuation and predictive factors in patients treated with GLP-1 receptor analogues: evidence from Sicilian distribution 'per conto' (DPC) data (2021-2024)",
  "uid": "1f183c9b-ef33-5f21-9eab-3010dff47a4f"
}