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

Abstract

IntroductionIn clinical trials, liraglutide has proven to be an effective drug for the treatment of type 2 diabetes mellitus (T2DM). The real-world effectiveness of liraglutide has been investigated in numerous studies. The aim of this systematic literature review is to collate evidence on the real-world clinical effectiveness of liraglutide.MethodsA review of publications from Medline, EMBASE, the Cochrane Library, and conference proceedings was conducted to identify observational studies that assessed the clinical effectiveness of liraglutide in real-world clinical practice. This review was conducted according to the National Institute of Health and Care Excellence (NICE) guidance. No language or time limits were applied, except to the conference proceedings (2013–2015). Endpoints for data extraction were decided a priori. Study quality appraisal was done for full-text journal articles.ResultsOf 124 publications included in the review, 43 were full-text articles. Liraglutide significantly reduces glycated hemoglobin (HbA1c) within 6 months of initiating treatment (mean change in HbA1c from baseline: −0.9% to −2.2%; HbA1c <7.0%: 29.5–65.0%). The NICE composite endpoint (HbA1c reduction ≥1% and weight reduction ≥3%) was met in 16.9–47.0% of patients with liraglutide treatment. Liraglutide therapy led to a mean change in absolute weight from baseline of −1.3 to −8.65 kg. Liraglutide treatment was well tolerated in patients with T2DM. The rate of occurrence of hypoglycemia with liraglutide monotherapy was ≤0.8%. Hypoglycemia was more common in patients taking antidiabetic medications (0.0–15.2%) together with liraglutide. The beneficial glycemic and weight effect of liraglutide therapy in patients with T2DM was maintained for at least 12 months.ConclusionEvidence from observational studies reflecting real-world clinical practice demonstrates that liraglutide therapy improves glycemic control with a low risk of hypoglycemia, and is associated with significant weight loss in patients with T2DM. These observations are consistent with clinical trial findings.FundingNovo Nordisk A/S, Søborg, Denmark.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-016-0180-0) contains supplementary material, which is available to authorized users.

Achieving glycaemic control without weight gain, hypoglycaemia, or gastrointestinal adverse events in type 2 diabetes in the SUSTAIN clinical trial programme

“…These findings are generally consistent with those from other studies and compare favourably with published data for other GLP‐1RAs 1, 6, 7, 21. For instance, a meta‐analysis of seven clinical trials in participants with T2D showed that 32% to 40% of participants receiving liraglutide achieved HbA1c <53 mmol/mol (7.0%) concentrations without weight gain or hypoglycaemia, vs 8% for placebo and 8% to 25% for comparators (exenatide, IGlar, sitagliptin, sulphonylureas or thiazolidinedione) 21.…”

“…GLP‐1RAs are effective at reducing HbA1c, body weight and inducing satiety 1, 6. Unlike therapy with insulin and sulphonylureas, GLP‐1RAs act by inducing glucose‐dependent insulin secretion and are associated with a low risk of hypoglycaemia and weight gain 1, 6, 7, 8. GLP‐1RAs are generally well tolerated,1 although gastrointestinal (GI) adverse events (AEs) are commonly observed across the class 2, 9…”

Effectiveness and Persistence of Liraglutide Treatment Among Patients with Type 2 Diabetes Treated in Primary Care and Specialist Settings: A Subgroup Analysis from the EVIDENCE Study, a Prospective, 2-Year Follow-up, Observational, Post-Marketing Study

“…These findings were verified in a recent systematic review of observational data [18]. Real-life clinical data assessed in an audit by The Association of British Clinical Diabetologists (ABCD) demonstrated that, after 6 months of treatment, liraglutide had effectively reduced HbA 1c and was well tolerated [19, 20].…”

Republished: Metformin-associated lactic acidosis precipitated by liraglutide use: adverse effects of aggressive antihyperglycaemic therapy

“…8 It has been approved by the Food and Drug Administration as an adjunct to diet and exercise for management of adult patients with type 2 diabetes. 9 The most common side effects of this medication are nausea and vomiting, which are particularly bothersome for patients during the first few weeks of treatment. 9 Indeed, these gastrointestinal symptoms can at times be severe enough to cause dehydration and precipitate acute kidney injury.…”

“…9 The most common side effects of this medication are nausea and vomiting, which are particularly bothersome for patients during the first few weeks of treatment. 9 Indeed, these gastrointestinal symptoms can at times be severe enough to cause dehydration and precipitate acute kidney injury. 10 …”