New Drug Liraglutide Is Promising in Type 2 Diabetes Treatment

Liraglutide a long-acting glucagons-like peptide 1 improved glycemic control in Type 2 diabetes without weight gain.

In a study of type 2 diabetic patients, treatment with liraglutide (NN2211), an investigational long-acting glucagon-like peptide 1 derivative administered by injection once daily, improved glycemic control without increasing weight, European investigators report in the June issue of Diabetes Care.

Commenting on his team’s findings, Dr. Sten Madsbad from Hvidovre Hospital in Denmark tstated that “insulin and sulfonylurea treatment also improve glycemic control, but increase weight. The present trial is the first to demonstrate long term improvement in glycemic control with a concomitant weight loss in type 2 diabetic patients.”

Dr. Madsbad and colleagues conducted a double-blind, parallel-group, placebo-controlled trial with an open-label comparator arm. Involved were 193 type 2 diabetics with a mean HbA1c of 7.6%. The researchers randomly assigned subjects to one of five fixed-dosage groups of liraglutide (0.045, 0.225, 0.45, 0.60, or 0.75 mg), placebo, or open-label sulfonylurea (glimepiride, 1-4 mg).

In intention-to-treat analysis based on 190 patients, HbA1c fell in all but the lowest liraglutide dosage group, the team reports. In the 0.75-mg liraglutide group, HbA1c fell by a significant 0.75 percentage points and fasting glucose by 1.8 mmol/L compared with placebo.

Improvement in glycemic control was observed after one week and maintained throughout the 12-week trial. After 12 weeks 59% of patients in the two highest liraglutide dosage arms achieved HbA1c of 7% or less.

Liraglutide 0.75-mg provided HbA1c and fasting serum glucose control comparable to the sulfonylurea comparator glimepiride, and there were “fewer hypoglycemic events in the liraglutide arm,” Dr. Madsbad added.

Moreover, patients taking liraglutide did not gain weight. In fact, subjects in the 0.45 mg liraglutide arm experienced a statistically significant 1.2 kg decrease in body weight compared with placebo. Body weight increased “slightly” in the glimepiride arm.

Thus the researchers conclude that the agent “shows considerable promise as a once-daily therapy in type 2 diabetes.” Diabetes Care 2004;27:1335-1342. PowerPoint Presentation Available