Efficacy and Safety of Switching From the DPP-4 Inhibitor Sitagliptin to the Human GLP-1 Analog Liraglutide After 52 Weeks in Metformin-Treated Patients With Type 2 Diabetes Article

Industry Collaboration International Collaboration

cited authors

  • Pratley, Richard E., Nauck, Michael A., Bailey, Timothy, Montanya, Eduard, Filetti, Sebastiano, Garber, Alan J., Thomsen, Anne B., Furber, Sabina, Davies, Melanie, 1860-LIRA-DPP-4 Study Grp

funding text

  • R.E.P. has attended advisory panels or acted as a consultant for AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Merck, Novartis, Novo Nordisk, Takeda, sanofi-aventis, MannKind, Roche, and Zealand and has received research grants or participated in clinical trials for Eli Lilly & Co., GlaxoSmithKline, Mann Kind, Merck & Co., Novartis Pharmaceuticals Corporation, Novo Nordisk Inc, Pfizer Inc., sanofi-aventis, Takeda, and Roche. M.A.N. has received research grants from Bayer Vital Pharma, Eli Lilly & Co., Menarini/Berlin-Chemie, Merck Sharp & Dohme, Novartis Pharma, and Novo Nordisk A/S and has accepted honoraria for membership on advisory boards and for consulting and has received honoraria for speaking on incretin-based antidiabetes medications from Amylin Pharmaceuticals, AstraZeneca, Bayer Vital Pharma, Menarini/Berlin-Chemie, Biovitrum, Boehringer Ingelheim, Eli Lilly & Co., GlaxoSmithKline, Hoffmann-La Roche, Novartis Pharma, Novo Nordisk A/S, sanofi-aventis, and Takeda. T.B. has attended advisory panels for Amylin Pharmaceuticals; has received research support from Animas Corporation, Becton Dickinson, CPEX Pharmaceuticals, Dexcom, Eli Lilly & Co., GlaxoSmithKline, Medtronic MiniMed, Merck, Novo Nordisk Inc., Resmed, and sanofi-aventis; and has attended speakers' bureaus for Amylin Pharmaceuticals Inc., Dexcom, Eli Lilly & Co., Medtronic MiniMed, Novo Nordisk Inc., Roche Diagnostics, and sanofi-aventis. E.M. has attended advisory panels for Merck Sharp & Dohme, Novartis, Novo Nordisk, and sanofi-aventis. S.Fi. has acted as consultant and has attended speakers' bureaus for Novo Nordisk A/S. A.J.G. is an advisor and speaker for GlaxoSmithKline, Merck & Co., Novo Nordisk, and Sankyo. A.B.T. is an employee of and shareholder in Novo Nordisk and was directly involved in study conduct. S.Fu. is an employee of and shareholder in Novo Nordisk. M.D. has acted as consultant, advisory board member, and speaker for Eli Lilly & Co., Merck Sharp & Dohme, Novanis, Novo Nordisk A/S, Roche, and sanofi-aventis; has acted as a speaker for Servier; and has received grants in support of investigator and investigator-initiated trials from Eli Lilly & Co., GlaxoSmithKline, Merck Sharp & Dohme, Novartis, Novo Nordisk NS, Pfizer, sanofi-aventis, and Servier. No other potential conflicts of interest relevant to this article were reported.

abstract

  • OBJECTIVE-To assess the efficacy and safety of switching from sitagliptin to liraglutide in metformin-treated adults with type 2 diabetes. RESEARCH DESIGN AND METHODS-In an open-label trial, participants randomized to receive either liraglutide (1.2 or 1.8 mg/day) or sitagliptin (100 mg/day), each added to metformin, continued treatment for 52 weeks. In a 26-week extension, sitagliptin-treated participants were randomly allocated to receive instead liraglutide at either 1.2 or 1.8 mg/day, while participants originally randomized to receive liraglutide continued unchanged. RESULTS-Although 52 weeks of sitagliptin changed glycosylated hemohlobin (HbA(1c)) by -0.9% from baseline, additional decreases occurred after switching to liraglutide (1.2 mg/day, -0.2%, P = 0.006; 1.8 mg/day, -0.5%, P = 0.0001). Conversion to liraglutide was associated with reductions in fasting plasma glucose (FPG) (1.2 mg/day, -0.8 mmol/L, P = 0.0004; 1.8 mg/day, -1.4 mmol/L, P < 0.0001) and body weight (1.2 mg/day, -1.6 kg; 1.8 mg/day, -2.5 kg; both P < 0.0001) and with an increased proportion of patients reaching HbA(1c) <7% (from c similar to 30% to similar to 50%). Overall treatment satisfaction, assessed by the Diabetes Treatment Satisfaction Questionnaire, improved after switching to liraglutide (pooled 1.2 and 1.8 mg/day, 1.3; P = 0.0189). After switching, mostly transient nausea occurred in 21% of participants, and minor hypoglycemia remained low (3-4% of participants). Continuing liraglutide treatment at 1.2 mg/day and 1.8 mg/day for 78 weeks reduced HbA(1c) (baseline 8.3 and 8.4%, respectively) by -0.9 and -1.3%, respectively; FPG by -1.3 and -1.7 mmol/L, respectively; and weight by -2.6 and -3.1 kg, respectively, with 9-10% of participants reporting minor hypoglycemia. CONCLUSIONS-Glycemic control, weight, and treatment satisfaction improved after switching from sitagliptin to liraglutide, albeit with a transient increase in gastrointestinal reactions.

authors

Publication Date

  • October 1, 2012

webpage

published in

category

start page

  • 1986

end page

  • 1993

volume

  • 35

issue

  • 10

WoS Citations

  • 41

WoS References

  • 32