Abstract

In Japan, society is aging. Additionally, dialysis is performed in one out of 400 people. Safe, effective and convenient therapies for elderly or renal impairment type 2 diabetic patients (T2D) including those undergoing dialysis are needed. We investigated the the long-term efficacy and safety of a new once weekly GLP-1RAg dulaglutide (Dura) on glycemic control in those. We conducted two different retrospective analyses of 2 year efficacy and safety of Dura in T2D according to; 1)subgroups stratified by ages (≤70 years old or >71 years old), 2) renal impairment including those undergoing dialysis. Regarding 1) Of 322 T2D, 214 elderly T2D (109 males, 76.6±6.9 years old, disease duration of 7.6±7.4 years, HbA1c 8.3±1.8%, BMI 24.1±4.1) and 1younger T2D (48 males, 58.4±10.6 years old, disease duration of 5.6±5.6 years, HbA1c 7.9±1.4%, BMI 25.5±4.4) were newly administered Dura weekly. Elderly and younger T2D treated with Dura achieved 7.0±6.9% and 7.2±6.9% in HbA1c after 2 years respectively. 20 elderly T2D were injected under help with care persons due to cognitive impairment. One patient discontinued Dura due to intolerance. Nocturnal hypoglycemia never occurred. 2) 33 patients with renal impairment (69.5±10.2 years old, HbA1c 7.6±1.0%, eGFR 42.3±7.9 mL/min/1.73m2) including 6 patients undergoing dialysis (5 hemodialysis and 1 peritoneal dialysis). The levels of eGFR remained those at the start of Dura therapy. Only one patient with hemodialysis discontinued Dura due to vomiting. Weekly GLP-1RAg provides more effective and safer glycemic control in elderly T2D with/without renal impairment including dialysis. It might be expected to reduce: patient burden due to weekly injections, risk of hypoglycemia, burden on care givers in an aging society. It might also be expected to improve QoL of patients due to a reduced burden when taking medicines daily or hypoglycemia, and due to saving care person’s burden in elderly society which is workforce shortage, result in reduce of medical costs. Disclosure S. Kaneko: Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S, Eli Lilly and Company, Mitsubishi Tanabe Pharma Corporation, Novartis Pharma K.K., Sanwa Kagaku Kenkyusho Co., Ltd.. Other Relationship; Self; Elsevier. Speaker's Bureau; Self; Kowa Pharmaceuticals America, Inc., Ono Pharmaceutical Co., Ltd., Astellas Pharma US, Inc., Sanofi, Nippon Boehringer Ingelheim Co. Ltd., AstraZeneca, Sumitomo Dainippon Pharma Co., Ltd.. Speaker's Bureau; Spouse/Partner; Sumitomo Dainippon Pharma Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Otsuka Holdings Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Biogen, Eisai Co., Ltd., Bayer AG, Novartis Pharma K.K., Ono Pharmaceutical Co., Ltd., Nihon Pharmaceutical Co., Ltd., Fujimoto Pharmaceutical Corporation. Y. Ueda: None. Y. Tahara: None.

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