Effectiveness of Liraglutide and Lixisenatide in the Treatment of Type 2 Diabetes: Real-World Evidence from The Health Improvement Network (THIN) Database in the United Kingdom

Feher, Michael; Vega-Hernández, Gabriela; Mocevic, Emina; Buysse, B.; Myland, Melissa; Power, G Sarah; Husemoen, Lise Lotte Nystrup; Kim, Joseph; Witte, Daniel R.

doi:10.1007/s13300-017-0241-z

Cited by 21 publications

(12 citation statements)

References 22 publications

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“…In this context, however, our study has confirmed the already well-defined clinical profile of lixisenatide. At the end of our study, 24.8% of patients receiving therapy achieved HbA1c levels below 7.0%, which echoes the response rates seen in the intention-to-treat (ITT) analysis of the GetGoal program with lixisenatide, but exceeds the ones recently reported in a real-life study, where lixisenatide was compared with liraglutide [ 16 ]. Whereas the higher percentage of patients reaching an HbA1c goal below 7% can be explained by the lower baseline HbA1c level in our study [8.7% (72 mmol/mol) vs. 9.5% (80 mmol/mol)], it is noteworthy that the reduction of HbA1c of about 0.7% is comparable in both studies, despite the lower HbA1c in this study.…”

Section: Discussionsupporting

confidence: 74%

Austrian Experience with Lixisenatide Under Real-Life Conditions: A Prospective Observational Study

Brath¹,

Abrahamian

Karuza

et al. 2019

Diabetes Ther

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Introduction Lixisenatide has been studied extensively in randomized clinical trials; however, data on its use in the real-life practice are scarce. Methods This study was a prospective, 26-week, multicenter, observational study conducted in Austrian diabetes centers and office-based practices to evaluate efficacy and safety of lixisenatide under real-life conditions in patients with type 2 diabetes. Results Out of 144 patients (mean BMI 36.4 kg/m 2 , disease duration 12.4 years), 113 completed the documentation at 6 months and 42% received basal insulin with or without oral antidiabetic drugs. The HbA1c declined from 8.7% (72 mmol/mol) to 7.9% (63 mmol/mol) and at study end 24.8% of the patients reached an HbA1c level below 7%. Fasting and postprandial glucose after lixisenatide administration were reduced by 27 ± 58 mg/dl and 45 ± 67 mg/dl, respectively. At study end body weight (− 4.5 ± 5.4 kg), triglycerides (− 10.8 ± 105 mg/dl), systolic blood pressure (− 4.8 ± 17.1 mmHg), and LDL cholesterol (− 3.7 ± 25 mg/dl) were reduced. The most commonly reported adverse events were gastrointestinal disorders (18.8%). Forty-three patients (30%) discontinued prematurely, mostly caused by lack of efficacy, occurrence of gastrointestinal disorders, and missing reimbursement. The average dose of insulin decreased slightly by 1.5 units (from 29.4 to 27.9). Conclusion Lixisenatide demonstrated a similar efficacy and safety profile under real-life conditions as previously shown in randomized clinical trials. Funding sanofi-aventis GmbH Austria.

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Section: Discussionsupporting

confidence: 74%

Austrian Experience with Lixisenatide Under Real-Life Conditions: A Prospective Observational Study

Brath¹,

Abrahamian

Karuza

et al. 2019

Diabetes Ther

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“…It also has the beneficial effects on the cardiovascular system [ 16 ]. The current study shows liraglutide can reduce the levels of blood glucose, fasting insulin, HOMA-IR, AST, ALT, BUN, TG and TC in the diabetic rats,which is similar to the results of clinical therapy for the diabetic patients [ 17 , 18 ]. The typical pathological characters of atherosclerosis are lipid accumulation, macrophages infiltration, foam cells forming, formation of plaques and thickening of artery intima.…”

Section: Discussionsupporting

confidence: 86%

Liraglutide attenuates atherosclerosis via inhibiting ER-induced macrophage derived microvesicles production in T2DM rats

Liu

Fang

et al. 2017

Diabetol Metab Syndr

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BackgroundWe investigated the effects of liraglutide on the formation and progression of atherosclerosis in type 2 diabetes mellitus (T2DM) rats.MethodsSprague–Dawley rats were divided into control group, diabetes group and liraglutide treated group. The T2DM rats model with atherosclerosis were induced by high fat diet followed small dosage streptozotocin injection. Body weight and blood glucose levels were monitored once a week for 3 months and then the rats were sacrificed.Peripheral blood and aorta tissues were collected for further biochemical and pathological estimation respectively. Moreover, immunohistochemistry staining was used to detect the infiltration of macrophages and cell apoptosis in tissue samples. The amount of microvesicles of atherosclerotic plaques was determined by ELISA. Western blot was applied to detect the protein expressions of CHOP, GRP78 and caspase-3 in tissue samples. The mRNA expressions of SREBP-1c and FAS were detected by RT-PCR.ResultsThe rat model of diabetic atherosclerosis was established successfully. Compared with the control group, glucose, triglycerides, total cholesterol, AST, ALT, BUN, fasting insulin and homeostatic model assessment insulin resistance levels in peripheral blood were significantly increased in the diabetes group. While, these indicators in the liraglutide group were significantly lower than that in the diabetes group. Moreover, the atherosclerotic plaques were observed in the rats of diabetes group but not remarkable in the liraglutide group. The ratio between aorta intima and media thickness was significantly greater in the diabetes group than that in the liraglutide group. Compared with the diabetes group, the infiltration and apoptosis of macrophages were milder in the liraglutide group. The expressions of CD68, caspase-3, CHOP and GRP78 in aorta tissue samples were significantly downregulated in the liraglutide group than that in the diabetes group. Furthermore, the microvesicles of aorta tissues in the liraglutide group were significantly decreased than that in the diabetes group. The mRNA expressions of SREBP-1c and FAS were lower in the liraglutide group than that in the diabetes group.ConclusionLiraglutide attenuates diabetic atherosclerosis by inhibition of ER stress and subsequent macrophage apoptosis and microvesicles production in T2DM rats.

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“…Still the proportion of patients experiencing a 1.0% HbA1c decrease in both cohorts was much smaller compared to our study results. The results from our study are much closer to the retrospective UK cohort study where the proportion of patients with at least 1.0% decrease in HbA1c was 76.0% for liraglutide and 63.6% for lixisenatide [ 14 ]. Still we need to have in mind the higher baseline HbA1c in the UK cohort which would suggest greater glycaemic response.…”

Section: Discussionsupporting

confidence: 80%

“…Moreover in all of the patients continuing lixisenatide treatment the maintenance dose was 20 µg. Another retrospective cohort study evaluating the real-world effectiveness of liraglutide and lixisenatide in UK also showed smaller reductions in HbA1c in T2D patients initiating a GLP-1RA in routine clinical practice [ 14 ]. In that study the observed change in HbA1c for 12 months was − 0.93% with liraglutide and − 0.70% with lixisenatide.…”

Section: Discussionmentioning

confidence: 99%

Real-World Effectiveness and Safety of Lixisenatide as Add-On to Oral Antidiabetic Drugs as Part of Routine Clinical Practice in Bulgaria: LIXODAR Study

et al. 2019

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Introduction This study aimed to demonstrate the beneficial effect of lixisenatide as add-on therapy to oral antidiabetics (OADs) in type 2 diabetes mellitus (T2DM) patients in routine clinical practice in Bulgaria. Methods This was a prospective, observational, multicentre study evaluating the real-life effectiveness and safety of 24-week treatment with lixisenatide in previously uncontrolled T2DM patients on combination therapy with metformin and sulfonylurea on highest tolerable doses. Results A total of 262 patients were included in the study. The mean (± SD) age in the cohort was 56.2 ± 9.1 years. The mean duration of diabetes was 7.3 ± 6.0 years. The mean body mass index (BMI) was 39.7 ± 4.7 kg/m 2 . The mean glycated haemoglobin (HbA1c) at baseline was 8.8 ± 1.1%. The mean fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) at baseline were 10.5 ± 3.1 mmol/L and 12.1 ± 3.4 mmol/L respectively. The proportion of patients achieving HbA1c < 7% at study end was 39.0% (95% CI 32.9–45.3). The proportion of patients reaching their individual HbA1c target was 49.0% (95% CI 42.6–55.4). The mean change in HbA1c from baseline was − 1.3 ± 1.2%. The mean change in FPG was − 2.4 ± 3.0 mmol/L and the mean change in PPG was − 3.2 ± 3.6 mmol/L. The mean body weight change from baseline was − 7.2 ± 5.5 kg. The mean BMI change was − 2.6 ± 1.9 kg/m 2 . The hypoglycaemia incidence was low: 6.1% for all hypoglycaemic events, 3.8% for symptomatic events and 0.4% for severe events. Conclusions Lixisenatide as add-on therapy to OADs in a real-life setting led to significant improvements in glycaemic control with low incidence of hypoglycaemia and beneficial weight loss. Lixisenatide was well tolerated with few patients having adverse events or discontinuing therapy. These findings are consistent with lixisenatide’s safety and efficacy profile established in randomized controlled trials (RCTs). Funding Sanofi Bulgaria. Electronic supplementary material The online version of this article (10.1007/s13300-019-0603-9) contains supplementary material, which is available to authorized users.

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Effectiveness of Liraglutide and Lixisenatide in the Treatment of Type 2 Diabetes: Real-World Evidence from The Health Improvement Network (THIN) Database in the United Kingdom

Cited by 21 publications

References 22 publications

Austrian Experience with Lixisenatide Under Real-Life Conditions: A Prospective Observational Study

Austrian Experience with Lixisenatide Under Real-Life Conditions: A Prospective Observational Study

Liraglutide attenuates atherosclerosis via inhibiting ER-induced macrophage derived microvesicles production in T2DM rats

Real-World Effectiveness and Safety of Lixisenatide as Add-On to Oral Antidiabetic Drugs as Part of Routine Clinical Practice in Bulgaria: LIXODAR Study

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