Glycaemic control with liraglutide: the phase 3 trial programme

Abstract

Aims: To review the efficacy and safety of liraglutide from the phase 3 trials, focusing primarily on glycaemic control.

Key findings: Liraglutide was shown to reduce glycated haemoglobin (HbA(1c) ) levels by up to 1.5% from baseline, significantly more than the comparators sitagliptin (-0.9%), glimepiride (-0.5%), rosiglitazone (-0.4%), insulin glargine (-1.1%) and exenatide (-0.8%). Both fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels were shown to be significantly reduced from baseline [up to -2.4 mmol/l (-43.2 mg/dl) and -2.7 mmol/l (-48.6 mg/dl) for FPG and PPG in the liraglutide 1.8 mg group, respectively]. Changes in HbA(1c) , FPG and PPG levels were sustained for the duration of the studies (up to 52 weeks). The glycaemic control offered by liraglutide was not associated with an increased rate of minor hypoglycaemic events compared with comparator treatments, with rates significantly lower than those of glimepiride and exenatide. Major hypoglycaemic events were rare and only occurred in combination with a sulfonylurea. Nausea was the most frequent adverse event, but subsided within the first few weeks.

Conclusions: Liraglutide has been shown to offer effective glycaemic control for patients with type 2 diabetes and is appropriate for use across the conventional continuum of care. Despite the sustained reductions in HbA(1c) , FPG and PPG levels achieved with liraglutide, rates of minor hypoglycaemia were generally low, although the risk increased when combined with a sulfonylurea. Liraglutide is therefore a promising new option for the treatment of type 2 diabetes.