Durable efficacy of liraglutide in patients with type 2 diabetes and pronounced insulin‐associated weight gain: 52‐week results from the Effect of Liraglutide on insulin‐associated <scp>wE</scp>ight <scp>GA</scp>iN in patients with Type 2 diabetes' (<scp>ELEGANT</scp>) randomized controlled trial

Wit, H.M. de; Vervoort, G.M.M.; Jansen, Henry; Galan, Bastiaan E. de; Tack, Cees J.

doi:10.1111/joim.12447

Cited by 14 publications

(16 citation statements)

References 33 publications

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“…Although treatment with liraglutide is expensive relative to other oral anti-diabetic drugs and reimbursement is limited in many healthcare systems, including Thailand, its use when other treatments fail or lead to significant side-effects may be suitable. Other studies21,22 have shown that liraglutide reverses pronounced insulin-associated weight gain, decreases insulin requirements, and improves glycemic control in T2DM patients. Such benefits may also result in additional cost savings, which are not included in the present study.…”

Section: Discussionmentioning

confidence: 95%

<p>Cost–benefit comparison of liraglutide and sitagliptin in the treatment of type 2 diabetes in Thailand</p>

Deerochanawong

Kosachunhanun

GADEKAR³

et al. 2019

CEOR

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Aim Liraglutide, a once-daily subcutaneous glucagon-like peptide-1 (GLP-1) agonist, is approved for treatment of hyperglycemia in patients with type 2 diabetes mellitus (T2DM). For patients with established cardiovascular diseases, liraglutide has also been shown to reduce major cardiovascular events. However, its cost is relatively higher than other oral antidiabetic drugs. This study aims to compare the costs and benefits of liraglutide vs sitagliptin, in treating T2DM in Thailand. Methods This study consists of two parts. In part 1, the cost of keeping T2DM under control per patient (HbA1c<7.0% with no reported hypoglycemia and no body weight gain) with liraglutide (1.2 and 1.8 mg daily) was compared with using sitagliptin (100 mg daily). Costs were based on Thai local data. Clinical outcomes were based on head-to-head randomized controlled trials. Part 2 estimated the cost-per-controlled patient, based on major cardiovascular outcomes (cardiovascular death, nonfatal myocardial infarction, non-fatal stroke). Economic benefit was calculated as the reduction in cardiovascular outcomes. Results In Thailand, liraglutide (1.8 mg daily) costs 7.37-times more than sitagliptin 100 mg. The cost per patient achieving a composite clinical endpoint (HbA1c<7.0%, with no weight gain and no hypoglycemic events) in patients with T2DM receiving liraglutide 1.8 mg is 2.80-times higher than patients receiving sitagliptin 100 mg. When cardiovascular benefits (reduced composite endpoint of major cardiovascular events, ie, cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke) were taken into account, it was found that liraglutide had lower cost than sitagliptin, resulting in estimated savings of 20,085 THB (620 USD) per patient per year. Conclusion The clinical benefits of liraglutide (HbA1c<7.0%, no hypoglycemia, no weight gain, reduced cardiovascular outcomes) partly offset its high price. Therefore, liraglutide should be considered as an appropriate treatment alternative to sitagliptin, particularly for T2DM patients with high cardiovascular risks.

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Section: Discussionmentioning

confidence: 95%

<p>Cost–benefit comparison of liraglutide and sitagliptin in the treatment of type 2 diabetes in Thailand</p>

Deerochanawong

Kosachunhanun

GADEKAR³

et al. 2019

CEOR

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show abstract

“…The frequency of hypoglycaemia was similar for both treatments, but gastrointestinal AEs were more common with liraglutide. A 52-week extension study of ELEGANT showed that the improvements in HbA 1c and body weight seen in the core study were sustained in the long term (Table 1) [44]. In a separate study of Japanese participants with Type 2 diabetes, 36 weeks of treatment with liraglutide added to an insulin regimen resulted in a significantly (P < 0.0001) greater reduction in HbA 1c than placebo and weight loss rather than weight gain [45].…”

Section: Treatment Intensification Of Basal Insulin With Glp-1rasmentioning

confidence: 97%

Use of glucagon‐like peptide‐1 receptor agonists among individuals on basal insulin requiring treatment intensification

Trautmann¹,

Vora

2018

Diabet. Med.

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As Type 2 diabetes progresses, treatment is intensified with additional therapies in an effort to manage hyperglycaemia effectively and therefore avoid complications. When greater efficacy is required, options for injectable treatments include glucagon‐like peptide‐1 receptor agonists and insulin, which may be added on to oral glucose‐lowering treatments. Among individuals receiving long‐acting basal insulin as their first injectable treatment, ~40−60% are unable to achieve or maintain their target HbA1c goals. For these people, treatment intensification options are relatively limited and include the addition of short‐acting prandial insulin or a glucagon‐like peptide‐1 receptor agonist. Glucagon‐like peptide‐1 receptor agonists vary in their effects, with short‐ and long‐acting agents having a greater impact on postprandial and fasting hyperglycaemia, respectively. Studies comparing treatment intensification options have found both glucagon‐like peptide‐1 receptor agonists and prandial insulin to be effective in reducing HbA1c concentrations; however, recipients of glucagon‐like peptide‐1 receptor agonists lost weight and had a greater frequency of gastrointestinal adverse events, whereas those receiving prandial insulin gained weight and had a greater incidence of hypoglycaemia. In addition to the separate administration of a glucagon‐like peptide‐1 receptor agonist and basal insulin, fixed‐ratio combinations of a glucagon‐like peptide‐1 receptor agonist and basal insulin offer a single administration for both treatments but have less flexibility in dose titration than treatment with their individual components. For individuals who require treatment intensification beyond basal insulin, use of these various options allows physicians to target the individual needs of their patients for the achievement of optimal long‐term glycaemic control.

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“…Twenty one studies with 7,437 participants (liraglutide group 4,509; placebo group 2,928) reported WC changes from the baseline [10][11][12][13][16][17][18]20,21,25,[27][28][29][30][32][33][34][36][37][38][39]. The WC was significantly reduced in the liraglutide group compared with the placebo group (MD −3.11 cm; 95% CI, −3.59 to −2.62) (Fig.…”

Section: Article In Pressmentioning

confidence: 99%

Efficacy and Safety of the New Appetite Suppressant, Liraglutide: A Meta-Analysis of Randomized Controlled Trials

et al. 2021

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Background: Obesity is a chronic disease associated with metabolic diseases such as diabetes and cardiovascular disease. Since the U.S. Food and Drug Administration approved liraglutide as an anti-obesity drug for nondiabetic patients in 2014, it has been widely used for weight control in overweight and obese people. This study aimed to systematically analyze the effects of liraglutide on body weight and other cardiometabolic parameters. Methods: We investigated articles from PubMed, EMBASE, and the Cochrane Library to search randomized clinical trials that examined body weight changes with liraglutide treatment. Results: We included 31 studies with 8,060 participants for this meta-analysis. The mean difference (MD) between the liraglutide group and the placebo group was −4.19 kg (95% confidence interval [CI], −4.84 to −3.55), with a −4.16% change from the baseline (95% CI, −4.90 to −3.43). Liraglutide treatment correlated with a significantly reduced body mass index (MD: −1.55; 95% CI, −1.76 to −1.34) and waist circumference (MD: −3.11 cm; 95% CI, −3.59 to −2.62) and significantly decreased blood pressure (systolic blood pressure, MD: −2.85 mm Hg; 95% CI, −3.36 to −2.35; diastolic blood pressure, MD: −0.66 mm Hg; 95% CI, −1.02 to −0.30), glycated hemoglobin (MD: −0.40%; 95% CI, −0.49 to −0.31), and low-density lipoprotein cholesterol (MD: -2.91 mg/dL; 95% CI, −5.28 to −0.53; MD: −0.87% change from baseline; 95% CI, −1.17 to −0.56). Conclusion:Liraglutide is effective for weight control and can be a promising drug for cardiovascular protection in overweight and obese people.

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Durable efficacy of liraglutide in patients with type 2 diabetes and pronounced insulin‐associated weight gain: 52‐week results from the Effect of Liraglutide on insulin‐associated wEight GAiN in patients with Type 2 diabetes' (ELEGANT) randomized controlled trial

Abstract: In T2DM patients with pronounced insulin-associated weight gain, addition of liraglutide within 2 years leads to sustained reversal of body weight, improved glycaemic control and decrease in insulin dose. Thus, liraglutide offers a valuable therapeutic option.

Cited by 14 publications

References 33 publications

<p>Cost–benefit comparison of liraglutide and sitagliptin in the treatment of type 2 diabetes in Thailand</p>

<p>Cost–benefit comparison of liraglutide and sitagliptin in the treatment of type 2 diabetes in Thailand</p>

Use of glucagon‐like peptide‐1 receptor agonists among individuals on basal insulin requiring treatment intensification

Efficacy and Safety of the New Appetite Suppressant, Liraglutide: A Meta-Analysis of Randomized Controlled Trials

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