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Meta-Analysis
. 2019 May;21(5):1255-1260.
doi: 10.1111/dom.13623. Epub 2019 Jan 22.

Comparative effectiveness of exenatide once-weekly versus liraglutide in routine clinical practice: A retrospective multicentre study and meta-analysis of observational studies

Gian Paolo Fadini  1 , Bendetta Maria Bonora  1 , Annunziata Lapolla  1 , Bruno Fattor  2 , Paola Silvia Morpurgo  3 , Natalino Simioni  4 , Angelo Avogaro  1 ; DARWIN-T2D Network
Affiliations
Meta-Analysis

Comparative effectiveness of exenatide once-weekly versus liraglutide in routine clinical practice: A retrospective multicentre study and meta-analysis of observational studies

Gian Paolo Fadini et al. Diabetes Obes Metab. 2019 May.

Abstract

In this study, we retrospectively compared the effectiveness of exenatide once-weekly (ExeOW) versus liraglutide in non-insulin treated patients with type 2 diabetes followed under routine care. We also present a meta-analysis of similar observational studies available in the literature. In our multicentre retrospective study, patients initiating ExeOW (n = 204) or liraglutide (n = 410) had similar baseline clinical characteristics. Change in HbA1c at 6 months was superimposable in the two groups (-0.7% ± 1.0%), and changes in body weight were also similar (ExeOW -2.2 ± 3.7 kg; liraglutide -2.5 ± 4.3 kg; p = 0.457). Discontinuation rates were numerically but not significantly lower for ExeOW versus liraglutide. Pooling these data with those of observational studies available in the literature yielded superimposable effects between the two groups for the change in HbA1c and body weight, with a higher risk of discontinuation (mainly based on pharmacy refill rates) for ExeOW. We conclude that, in patients under routine care, initiation of ExeOW provides similar benefits on HbA1c and body weight as initiation of liraglutide. These data help view the results of randomized controlled trials from the perspective of their application in routine clinical practice.

Keywords: antidiabetic drug; cohort study; exenatide; liraglutide; type 2 diabetes.

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Conflict of interest statement

Author contributions

Study design: G.P.F. and A.A. Data collection and analysis: G.P.F., B.M.B., A.L., B.F., P.S.M. and N.S. Manuscript writing: G.P.F and A.A. Manuscript revision: G.P.F., B.M.B., A.L., B.F., P.S.M., N.S. and A.A. All authors approved the final version of the manuscript.

Figures

Figure 1
Figure 1
Comparative effectiveness. A, HbA1c values at baseline and at follow‐up are plotted for patients who received liraglutide (Lira) or exenatide OW (ExeOW); *p < 0.05 using paired Student's t test. B, The change versus baseline in HbA1c in the two groups. C, Body weight at baseline and at follow‐up are plotted for the two groups of patients (*p < 0.05 using paired Student's t test). D, The change versus baseline in body weight in the two groups. Error bars indicate standard error
Figure 2
Figure 2
Meta‐analysis of observational studies comparing exenatide OW (ExeOW) and liraglutide (Lira). A, The meta‐analysis flowchart. Panels B‐D show the forest plots for the 3 outcomes considered: B, change in HbA1c, C, change in body weight and D, discontinuation rates. In the paper by McAdam‐Marx et al.,13 unadjusted data were recorded for the change in HbA1c and body weight, and, for the change in HbA1c, only the insulin‐free subgroup was considered. In the paper by Otto et al.,15 cohort 1 was considered, which was composed by GLP‐1RA initiators, while cohort 2 was composed by intra‐class switchers. In the paper by Yu et al20 the unmatched cohorts were considered. WMD, weighted mean difference; RR, risk ratio, Q and I2 are tests for homogeneity and heterogeneity of effect sizes
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References

    1. Aroda VR. A review of GLP‐1 receptor agonists: evolution and advancement, through the lens of randomised controlled trials. Diabetes Obes Metab. 2018;20(suppl 1):22‐33. - PubMed
    1. Hernandez AF, Green JB, Janmohamed S, et al. Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double‐blind, randomised placebo‐controlled trial. Lancet. 2018;392:1519‐1529. - PubMed
    1. Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375:1834‐1844. - PubMed
    1. Marso SP, Daniels GH, Brown‐Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375:311‐322. - PMC - PubMed
    1. Holman RR, Bethel MA, Mentz RJ, et al. Effects of once‐weekly exenatide on cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2017;377:1228‐1239. - PMC - PubMed

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