Lixisenatide improves glycemic outcomes of Japanese patients with type 2 diabetes: a meta-analysis

Abstract

BackgroundThe GetGoal-L-Asia and -S trials were multi-center trials conducted in 4 and 16 countries, respectively including Japan that evaluated the efficacy and safety of lixisenatide add-on treatment vs. placebo among patients with type 2 diabetes. The aims of this study were to determine the efficacy and safety of lixisenatide add-on treatment among Japanese patient groups.MethodsAll Japanese intent-to-treat patients with baseline and endpoint HbA1c measurements were included in the meta-analyses. Subgroup analyses were carried out for patients with low (<8 %) and high (≥8 %) baseline HbA1c levels, low (<25 kg/m2) and high (≥25 kg/m2) baseline body mass index (BMI), short (<10 years) and long (≥10 years) durations of diabetes, and for those <65 and ≥65 years of age.ResultsThe overall study population of Japanese type 2 diabetes patients included 143 patients (mean age: 59.0 years; 35 % female) treated with lixisenatide and 136 patients treated with placebo (mean age: 57.8 years; 32 % female). Among the subgroups, lixisenatide treatment vs. placebo was associated with greater change in HbA1c (Low HbA1c −0.80 %, p < 0.0001; High HbA1c −1.19 %, p < 0.0001; low BMI −0.88 %, p < 0.0001; high BMI −1.28 %, p < 0.0001; short diabetes duration −1.28 %, p < 0.0001; long diabetes duration −0.93 %, p < 0.0001; <65 years: −1.00 %, p < 0.0001; ≥65 years −1.24 %, p < 0.0001). Additionally, among the subgroups, lixisenatide treatment vs. placebo was associated with greater change in post-prandial glucose.ConclusionsFor Japanese type 2 diabetes patients lixisenatide may be an efficacious and safe add-on therapy leading to improved glycemic outcomes.GetGoal-L-Asia NCT01169779GetGoal-S NCT00713830

Efficacy and Safety of Dulaglutide by Baseline HbA1c in Chinese Patients with Type 2 Diabetes: A Post Hoc Analysis

“…The observed effect is due to the greater potential for improvement in glycemic control in patients with higher baseline HbA1c. Similar relationships between HbA1c levels and improvements in glycemic control have also been identified in previous reports of metaanalyses of various glucose-lowering therapies [18], meta-analyses of GLP-1RAs other than dulaglutide [19], and global phase III studies of dulaglutide [9]. Similarly, the FBG reductions were consistent with HbA1c reductions in both dulaglutide doses.…”

Efficacy and safety of subgroup analysis stratified by baseline HbA1c in a Japanese phase 3 study of dulaglutide 0.75 mg compared with insulin glargine in patients with type 2 diabetes

“…This is because there is a greater potential for improvement in glycemic control in patients with higher baseline HbA1c. Similar relationships between baseline HbA1c levels and improvements in glycemic control have also been seen in previous reports of meta-analyses of various glucose-lowering therapies [13], meta-analyses of GLP-1 receptor agonists other than dulaglutide [14,15], and global phase 3 studies of dulaglutide [16].…”

Efficacy and safety of oral semaglutide in Japanese patients with type 2 diabetes: A subgroup analysis by baseline variables in the PIONEER 9 and PIONEER 10 trials

“…This pattern was also observed in a subgroup analysis of once‐weekly s.c. semaglutide in a global population, although that analysis had a greater number of HbA 1c subgroups 27 . Furthermore, similar findings were also observed in subgroup analyses of Japanese patients who received other GLP‐1RAs, specifically dulaglutide 0.75 mg 28 and lixisenatide 20 μg 29 . These findings are in line with the known glucose‐dependent mechanism of action of GLP‐1RAs, which activate the GLP‐1 receptor only in the presence of elevated levels of glucose, leading to stimulation of insulin secretion and suppression of glucagon secretion (known as the incretin effect) 30 , 31 .…”