Efficacy of Liraglutide in a Real-Life Cohort

Abstract

IntroductionIn the Liraglutide Effect and Action in Diabetes (LEAD) randomized clinical trials (RCTs) assessing liraglutide in type 2 diabetes mellitus (T2DM), glycated hemoglobin (A1c) was reduced by 7–16 mmol/mol and weight by up to 3.4 kg. As real-life efficacy data on liraglutide is limited, the authors assessed clinical effects in a real-life cohort.MethodsIn this retrospective analysis from the Israeli Health Maintenance Organization Maccabi, of patients with T2DM, treated with liraglutide ≥6 months during 2011–2012, evaluations were performed at baseline and 6 months.ResultsInsulin-naïve patients (n = 1,101) treated with liraglutide with at least one A1c or weight measurement were identified. In 933 patients with an additional A1c value after 6 months, A1c decreased by 9 mmol/mol (p < 0.0001, 95% CI 7–11) from 72 mmol/mol. In patients receiving >2 oral antidiabetic drugs (OADs) prior to liraglutide treatment (80.7% patients), A1c decreased by 7 mmol/mol, and in those receiving ≤2 OADs, by 12 mmol/mol. In 453 patients with baseline data available, weight decreased by 2.55 kg (p < 0.0001); 173 patients (38.18%) achieved ≥1% A1c reduction. Furthermore, 91 patients (20.1%) achieved National Institute for Health and Care Excellence (NICE) criteria (decreased A1c ≥1%; weight ≥3%). Weight reduction was marginally correlated with A1c reduction.ConclusionsEvidence from real-life use of liraglutide demonstrated clinical effects similar to those demonstrated in RCTs.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-014-0062-2) contains supplementary material, which is available to authorized users.

Interindividual differences in the clinical effectiveness of liraglutide in Type 2 diabetes: a real‐world retrospective study conducted in Spain

“…Other variables such as age and treatment with other OADs did not significantly affect HbA 1c improvement. Similarly, previous studies identified that the number of OADs taken are not significant predictors of glycaemic response [16,19,27]. Remarkably, there was a considerable increase in the number of missing values over time, which resulted in predicted smooth functions with a high dispersion at long-term time points.…”

Clinical Effectiveness of Liraglutide in Type 2 Diabetes Treatment in the Real-World Setting: A Systematic Literature Review

“…The majority of the studies assessed the clinical effectiveness of liraglutide without an active comparator (81.4%; N  = 35) [28, 29, 31, 34, 36–39, 41–49, 51–55, 57, 60–64, 66–71]. Real-world studies with comparators were less frequently observed (18.6%; N  = 8); the most common comparators for liraglutide were: sitagliptin or any DPP-4i ( N  = 6) [32, 33, 35, 40, 56, 58], exenatide ( N  = 3) [33, 35, 50], glimepiride or any other SUs ( N  = 2) [30, 35], pioglitazone or other TZDs ( N  = 1) [35], and MET ( N  = 1) [35]; note: these numbers do not add up because some studies had more than one comparator.…”

Liraglutide for Type 2 diabetes and obesity: a 2015 update

“…An extensive clinical trial program (see Section 'Pharmacokinetic properties of liraglutide') and evidence from the real-world clinical practice setting [113,114] have firmly established the efficacy of liraglutide both as monotherapy and as add-on therapy compared with other antidiabetic agents. Thus, liraglutide 1.2 and 1.8 mg daily monotherapy or add-on therapy to one or more OADs improved glycemic control, body weight and SBP to a significant greater extent than placebo monotherapy or add-on therapy.…”