MedWire News: Patients with Type 2 diabetes treated with liraglutide have greater reductions in glycated hemoglobin (HbA1c), weight, and blood pressure than those treated with glimepiride, show results from the LEAD-3 Mono study.
Recent studies suggest that the antidiabetic drug liraglutide has advantages over other more conventional antidiabetic medications, such as the sulfonylurea glimepiride, as it acts in a glucose-dependent manner, stimulating insulin secretion only when blood glucose is high and thereby lessening the risk for treatment related hypoglycemia. It is also thought to decrease appetite and help with weight loss.
In LEAD 3 Mono (the Liraglutide versus glimepiride monotherapy for Type 2 diabetes Study), Alan Garber (Baylor College of Medicine, Houston, Texas, USA) and team carried out a double-blind study of 746 patients with early stage Type 2 diabetes who were randomized to take liraglutide 1.2 mg/day (n=251), liraglutide 1.8 mg/day (n=247), or glimepiride 8 mg/day (n=248) for a period of 52 weeks.
As reported in The Lancet, at 52 weeks Hb1Ac had decreased by 0.51%, 0.84%, and 1.14%, in the glimepiride, liraglutide 1.2 mg/day, and liraglutide 1.8 mg/day groups, respectively.
In addition, patients taking liraglutide lost between 2 and 3 kg in weight over the study, whereas those taking glimepiride gained around 1 kg over the same period.
Systolic blood pressure was reduced by 2.1 and 3.6 mmHg in the liraglutide 1.2 mg/day and 1.8 mg/day groups, respectively, compared with a reduction of only 0.7 mmHg in the glimepiride group. Diastolic blood pressure was also decreased in all groups, but only slightly and nonsignificantly.
Garber et al note that six liraglutide and no glimepiride treated patients discontinued treatment due to vomiting. Two patients treated with liraglutide developed pancreatitis. Generally, however, adverse events were minimal and mild.
“On the basis of these results, we conclude that liraglutide is safe and effective as initial pharmacological therapy for Type 2 diabetes mellitus,” conclude the researchers.
They add that it has advantages over other monotherapy drugs as it produces “greater reductions in weight, the number of hypoglycemic events, and systolic blood pressure.”
Sten Madsbad (University of Copenhagen, Denmark) said in an accompanying commentary: “The incretin-based [liraglutide] therapies offer new options in the treatment of Type 2 diabetes.
“However, their final role in the therapy of Type 2 diabetes remains to be clarified, after carefully conducted long-term trials with cardiovascular endpoints and safety data.”
MedWire is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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