Liraglutide therapy in obese people with type 2 diabetes - experience of a weight management centre

Liraglutide for the treatment of type 2 diabetes mellitus: a meta-analysis of randomized placebo-controlled trials

INTRODUCTION

Liraglutide has been widely used in the treatment of type 2 diabetes mellitus (T2DM), however, the results of a number of randomized placebo-controlled trials on the effects of liraglutide for the treatment of T2DM have varied. The purpose of this study was to assess the effects of liraglutide versus placebo for the treatment of T2DM.

METHODS

We searched randomized controlled trials comparing liraglutide and placebo for the treatment of T2DM in the following databases: MEDLINE; EMBASE; Cochrane Library Central Register of Controlled Trials; and Clinical Trials Gov (through August 2014). The standard mean difference (SMD) was calculated for the continuous data and a χ (2) test was used to evaluate heterogeneity.

RESULTS

Initially, 103 articles were retrieved through the literature search and 11 studies met the requirements for the meta-analysis. The effects of liraglutide on lowering glycosylated hemoglobin, fasting plasma glucose, reducing weight, lowering blood pressure, and the prevalence of adverse events were significantly different from placebo (P < 0.0001, SMD = -0.96, 95% CI = [-1.20, -0.73]; P < 0.0001, SMD = -0.72, 95% CI = [-0.99, -0.45]; P = 0.004, SMD = -0.24, 95% CI = [-0.40, -0.07]; P = 0.021, SMD = -0.15, 95% CI = [-0.27, -0.02], and P = 0.007, respectively).

CONCLUSION

Liraglutide had greater hypoglycemic, weight-reducing and systolic blood pressure-lowering effects than placebo. However, there were more adverse events in the treatment with liraglutide. It is suggested that additional well-designed, large, studies be conducted to further support the use of liraglutide and provide objective guidance for clinical application of liraglutide.

Clinical effectiveness of liraglutide across body mass index in patients with type 2 diabetes in the United States: a retrospective cohort study

INTRODUCTION

Clinical trials have shown that liraglutide effectively lowers glycated hemoglobin A1c (A1C) levels in adult patients with type 2 diabetes (T2D). However, no studies have evaluated the effectiveness of liraglutide by body mass index (BMI) in the United States (US) in clinical practice. This study examined liraglutide's clinical effectiveness to lower A1C and body weight after 6 months in T2D patients stratified by baseline BMI.

METHODS

This was a retrospective cohort study using the General Electric Centricity electronic medical records database. Adult patients with T2D (≥18 years and BMI≥ 25 kg/m(2)) and A1C >7% at baseline who started liraglutide between January 1, 2010 and January 31, 2013 and who did not use insulin or a glucagon-like peptide-1 analog 12 months before initiating liraglutide (N = 3,005) were selected. Changes from baseline, stratified by BMI, in A1C, body weight, A1C <7% goal attainment, and incidence of severe hypoglycemia at 6-month follow-up were examined.

RESULTS

After 6 months, A1C levels decreased on average by 0.95%, 1.02%, 0.99%, and 0.84% for BMI categories 25.0-29.9 (n = 333), 30.0-34.9 (n = 793), 35.0-39.9 (n = 821), and ≥40.0 kg/m(2) (n = 1,058), respectively (P = 0.30). The proportions of patients achieving A1C <7% at 6 months were 38.2%, 37.0%, 40.9%, and 41.0% (P = 0.54). The absolute body weight decreased by 1.5 to 4.0 kg across BMI and the rate of severe hypoglycemia (0.2%) was low.

CONCLUSION

Patients with T2D experienced statistically significant decreases in A1C and body weight after initiating liraglutide regardless of their BMI. Liraglutide reduced A1C equally well across baseline BMI in clinical practice in the US.