Dulaglutide is an effective treatment for lowering HbA1c in patients with type 2 diabetes regardless of body mass index

Abstract

Aim To assess the relationship between baseline body mass index (BMI) and glycaemic control in dulaglutide‐treated patients, a post hoc analysis was conducted on HbA1c and baseline BMI data from eight AWARD studies, with a total of 5770 patients. Materials and methods Changes from baseline in HbA1c data from patients treated with 1.5 mg or 0.75 mg dulaglutide, active comparator or placebo, were analyzed in each study (AWARD‐1 to −6, −8 and − 9) at approximately 6 months (26, 24 and 28 weeks, respectively). Within each study, data were analyzed by the following baseline BMI categories: <30, ≥30 to <35, and ≥ 35 kg/m2. Results In this post hoc analysis, 1.5 mg or 0.75 mg dulaglutide treatment achieved statistically significant HbA1c reductions from baseline in all BMI categories (least‐squares mean change from −0.62 to −1.75%) across the AWARD studies. No statistically significant treatment‐by‐BMI category interactions were found for reductions in HbA1c. Conclusion This post hoc analysis of eight AWARD studies indicates that baseline BMI does not affect the relative treatment efficacy of dulaglutide as measured by HbA1c change from baseline in any study. Dulaglutide is an effective treatment option for adult patients with type 2 diabetes regardless of their baseline BMI category.

HbA1c Reduction in Dulaglutide-Treated Patients Irrespective of Duration of Diabetes, Microvascular Disease, and BMI: A Post Hoc Analysis From the REWIND Trial

“…These results are consistent with the AWARD trials, which showed that neither baseline BMI nor duration of diabetes was associated with patients' responses to dulaglutide (3)(4)(5). Previous AWARD studies showed that treatment with dulaglutide results in HbA 1c reduction early in treatment in populations of study patients at lower risk for CVD (10)(11)(12)(13)(14).…”

“…Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of glucose-lowering drugs used to treat type 2 diabetes and include dulaglutide. Post hoc analysis of the Assessment of Weekly AdministRation of LY2189265 in Diabetes (AWARD) trials suggests that the 6-month glycemic effect of dulaglutide is independent of BMI and duration of diabetes (3)(4)(5). Whether these characteristics or the presence of microvascular disease affects glucose lowering during short-or long-term therapy remains unknown (6).…”

Durability of glucose-lowering effect of dulaglutide in patients with type 2 diabetes mellitus: A real-world data study

“…Results of our analysis comparing BMI subgroups did not differ from those of the post-hoc analysis of the AWARD trials, showing no significant differences in HbA1c reduction levels among the subgroups ( 24 ). However, the mean baseline BMI levels in the AWARD trials, ranging between 31.2 and 33.3 kg/m 2 , were greater compared with the corresponding levels of 27.99 kg/m 2 in our study.…”

Predictors of efficacy of Sodium‐GLucose Transporter‐2 inhibitors and Glucagon‐Like Peptide 1 receptor agonists: A retrospective cohort study

“…In addition, there is no moderating effect of BMI on HbA1c reduction with GLP1 receptor agonists, which appears to be similar in obese and lean patients. This latter result is in line with reports from randomized clinical trials 26 and cohort studies 27 . The effect of initial HbA1c on the incidence of treatment failure depends on the definition of success: if success is defined as the attainment of pre‐defined target HbA1c levels, a higher HbA1c level should be expected to be associated with a higher proportion of failures; on the other hand, if success is defined as a pre‐determined absolute reduction of HbA1c levels, such a target could be easier to reach in patients with higher baseline HbA1c.…”