LIRAGLUTIDE ACHIEVES A1C TARGETS MORE OFTEN THAN SITAGLIPTIN OR EXENATIDE WHEN ADDED TO METFORMIN IN PATIENTS WITH TYPE 2 DIABETES AND A BASELINE A1C < 8.0% Article

Industry Collaboration International Collaboration

cited authors

  • King, Allen B., Montanya, Eduard, Pratley, Richard E., Blonde, Lawrence, Svendsen, Claus Bo, Donsmark, Morten, Sesti, Giorgio

funding text

  • Dr. King has received honoraria and/or research support from Amylin, Animas, AstraZeneca, Eli Lilly & Co, Medtronic, Novo Nordisk, and Sanofi. Dr. Montanya has received honoraria and/or research support from Eli Lilly & Co, Intarcia Therapeutics, Merck, Sharp & Dohme, and Novo Nordisk. Dr. Pratley has received honoraria and/or research support from Eisai, Eli Lilly & Co, GlaxoSmithKline, Mannkind, Merck, Novartis, Novo Nordisk, Pfizer, Sanofi and Takeda; as of 6/11 all honoraria are directed to a non-profit organization. Dr. Blonde has received honoraria and or research support from Amylin, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly & Co, GlaxoSmithKline, Johnson & Johnson, Merck, Novo Nordisk, Orexigen Therapeutics, Sanofi, Santarus, and VeroScience. Dr. Svendsen and Dr. Donsmark are shareholders and employees of Novo Nordisk A/S. Dr. Sesti has received honoraria and or research support from Boehringer Ingelheim, Eli Lilly & Co, GlaxoSmithKline, Intarcia, Merck, Novo Nordisk, Sanofi, Servier, and Sigma-Tau.

abstract

  • Objective: Compare the safety and efficacy of liraglutide to that of sitagliptin or exenatide as add-on to metformin in patients with type 2 diabetes (T2D) and glycated hemoglobin (A1C) <8.0%. Methods: Post hoc analysis of 26-week data from liraglutide 1.8 mg once daily (OD) versus exenatide 10 mu g twice daily (LEAD-6) and liraglutide 1.8 mg OD versus sitagliptin 100 mg OD (LIRA-DPP-4); only patients treated as add-on to metformin with baseline A1C <8.0% were included. Efficacy analysis was performed on the intention-to-treat population with missing values imputed by last observation carried forward. Results: More patients achieved A1C targets (<7.0% and <= 6.5%) with liraglutide versus exenatide or sitagliptin; the difference was greatest for A1C <= 6.5% (LEAD-6: 65% versus 35%; odds ratio [OR]=3.37, 95% confidence interval [CI]: 1.31-8.63; P = .01 or LIRA-DPP-4: 53% versus 19%; OR = 4.78, 95% CI 2.10 to 10.87; P = .0002). Significantly more patients achieved a composite endpoint of A1C <7.0% with no weight gain or hypoglycemia with liraglutide compared with exenatide (78% versus 42%; OR = 4.99, 95% CI: 1.77 to 14.04; P = .0023) or sitagliptin (61% versus 21%; OR = 5.95, 95% CI: 2.66 to 13.29; P<.0001). All treatments were well tolerated, there was no major hypoglycemia and few patients (8 to 10%) experienced minor hypoglycemia. Conclusion: When added to metformin in patients with an A1C <8.0%, more patients using liraglutide 1.8 mg reached A1C targets than with exenatide or sitagliptin. Sitagliptin had particularly low efficacy in this analysis. These data support the use of liraglutide 1.8 mg as a safe and effective alternative to sitagliptin or exenatide following metformin failure in patients with an A1C <8.0%. (Endocr Pract. 2013; 19: 64-72)

authors

Publication Date

  • January 1, 2013

webpage

published in

category

start page

  • 64

end page

  • 72

volume

  • 19

issue

  • 1

WoS Citations

  • 12

WoS References

  • 36