Liraglutide may improve glycemic control in patients with type 2 diabetes

A clinical study showed patients who switched from exenatide twice daily to liraglutide once daily experienced further reductions in hemoglobin A1c and weight loss when added to oral antidiabetes drugs (OADs).

The LEAD 6 extension study evaluated the efficacy and safety of switching patients from exenatide to liraglutide.

LEAD 6 was a 26-week randomized, open-label study in patients with type 2 diabetes comparing the efficacy and safety of liraglutide 1.8 mg, once a day + OAD, to exenatide 10 µg, twice a day + OAD. In the 14-week extension, patients were switched from exenatide 10 µg to liraglutide. Exenatide patients were switched to liraglutide by titrating the liraglutide dose in 0.6-mg increments weekly to reach the target dose of 1.8 mg per day. Patients randomly assigned to liraglutide in the initial phase of the study continued on the 1.8-mg dose.

For patients switched to the liraglutide 1.8-mg group, mean HbA1C decreased from 7.2% at week 26 to 6.9% at week 40 (-0.32±0.043%). A greater percentage of patients reached their HbA1C targets after switching from exenatide to liraglutide (42.5% vs 57.9%).

Switched patients also experienced further reductions in fasting plasma glucose (FPG) (0.9±0.16 mmol/L), body weight (-1.98±0.33 lbs), and systolic blood pressure (SBP) (-3.8±0.84 mmHg). In those continuing with liraglutide, there were reductions in FPG (-0.2±0.11 mmol/L), body weight (-0.88±0.33 lbs), and SBP (-2.2±0.88 mmHg).

Similar numbers of patients reported adverse events in the extension. The most common adverse events reported were diarrhea and nausea.

“Because [liraglutide] and exenatide are the only GLP-1 agonists currently available, we were very interested to see if there were clinically meaningful differences in the effect of switching from exenatide to liraglutide in people with type 2 diabetes,” said John Buse, MD, chief of endocrinology and director of the Diabetes Care Center at the University of North Carolina School of Medicine, and one of the principal investigators in the study. “Clinical benefits were seen in patients who switched from exenatide to [liraglutide]. The significant improvements in blood sugar lowering and fasting glucose confirm the original findings of the trial regarding the efficacy of liraglutide.”