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Achieving a clinically relevant composite outcome of an HbA1c of <7% without weight gain or hypoglycaemia in type 2 diabetes: a meta-analysis of the liraglutide clinical trial programme.

AbstractAIM:
Effective type 2 diabetes management requires a multifactorial approach extending beyond glycaemic control. Clinical practice guidelines suggest targets for HbA1c, blood pressure and lipids, and emphasize weight reduction and avoiding hypoglycaemia. The phase 3 clinical trial programme for liraglutide, a human glucagon-like peptide 1 analogue, showed significant improvements in HbA1c and weight with a low risk of hypoglycaemia compared to other diabetes therapies. In this context, we performed a meta-analysis of data from these trials evaluating the proportion of patients achieving a clinically relevant composite measure of diabetes control consisting of an HbA1c <7% without weight gain or hypoglycaemia.
METHODS:
A prespecified meta-analysis was performed on 26-week patient-level data from seven trials (N = 4625) evaluating liraglutide with commonly used therapies for type 2 diabetes: glimepiride, rosiglitazone, glargine, exenatide, sitagliptin or placebo, adjusting for baseline HbA1c and weight, for a composite outcome of HbA1c <7.0%, no weight gain and no hypoglycaemic events.
RESULTS:
At 26 weeks, 40% of the liraglutide 1.8 mg group, 32% of the liraglutide 1.2 mg group and 6-25% of comparators (6% rosiglitazone, 8% glimepiride, 15% glargine, 25% exenatide, 11% sitagliptin, 8% placebo) achieved this composite outcome. Odds ratios favoured liraglutide 1.8 mg by 2.0- to 10.5-fold over comparators.
CONCLUSIONS:
As assessed by the composite outcome of HbA1c <7%, no hypoglycaemia and no weight gain, liraglutide was clearly superior to the other commonly used therapies. However, the long-term clinical impact of this observation remains to be shown.
AuthorsB Zinman, W E Schmidt, A Moses, N Lund, S Gough
JournalDiabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 14 Issue 1 Pg. 77-82 (Jan 2012) ISSN: 1463-1326 [Electronic] England
PMID21883806 (Publication Type: Journal Article, Meta-Analysis)
Copyright© 2011 Blackwell Publishing Ltd.
Chemical References
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Liraglutide
  • Glucagon-Like Peptide 1
Topics
  • Clinical Trials, Phase III as Topic
  • Diabetes Mellitus, Type 2 (blood, drug therapy)
  • Female
  • Glucagon-Like Peptide 1 (administration & dosage, adverse effects, analogs & derivatives)
  • Glycated Hemoglobin (drug effects)
  • Humans
  • Hypoglycemia (blood, chemically induced, prevention & control)
  • Hypoglycemic Agents (administration & dosage, adverse effects)
  • Liraglutide
  • Male
  • Middle Aged
  • Weight Gain (drug effects)

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