Predictors of treatment response to liraglutide in type 2 diabetes in a real-world setting

Simioni, Natalino; Berra, Cesare; Boemi, Massimo; Bossi, Antonio; Candido, Riccardo; Cianni, Graziano Di; Frontoni, Simona; Genovese, Stefano; Ponzani, Paola; Provenzano, Vincenzo; Russo, Giuseppina; Sciangula, L; Lapolla, Annunziata; Bette, Cristiano; Rossi, Maria Chiara

doi:10.1007/s00592-018-1124-0

Cited by 19 publications

(18 citation statements)

References 21 publications

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“…This would argue for an independent assessment of the reduction in weight and glycemia in the decision to continue GLP-1RAs therapy, which is further supported by the results of the multivariate analysis. The most important predictor of the reduction of ≥1% in HbA1c was a high baseline value, as previously reported by both observational studies and RCTs [45,46,47,48,49], and the odds were independent of the baseline BMI. Besides, a high initial BMI is the most important determinant of a weight reduction of ≥3%, which is also in line with other studies [50], and the likelihood was in turn independent of the baseline HbA1c.…”

Section: Discussionsupporting

confidence: 75%

“…The independent likelihood of achieving a beneficial change in glycemia and weight loss has been previously observed [26,27,45,49,50,51], and the weak or absent correlation between the magnitude in HbA1c and weight loss is not new [26,27,34,50,51]. The reasons for this could relate to the pleiotropic actions and distinct physiopathological pathways triggering each of the effects [43], and the patient-to-patient variability in the degree of improvement in glycemia and weight could be partially attributed to an underlying differential biological response.…”

Section: Discussionmentioning

confidence: 88%

“…However, based on other data from the CatSalut Pharmacy Register in the years of the present study, the vast majority of them (90%) were weekly formulations. Besides, we could not differentiate between doses of liraglutide, although the highest dose (1.8 µg/day) has been reported as more efficacious and a factor predicting the reduction of HbA1c ≥ 1.0% [49].…”

Section: Discussionmentioning

confidence: 99%

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Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia

Franch-Nadal

Mata-Cases

Ortega

et al. 2019

JCM

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To assess the clinical characteristics, the prescription pattern of GLP-1 receptor agonists (GLP-1RA) users, and HbA1c and weight change, we retrospectively assessed patients with type 2 diabetes by initiating GLP-1RA as an add-on to the standard of care in Catalonia. The mean change from the baseline in glycated hemoglobin (HbA1c) and weight at 6 and 12 months of therapy was calculated, and we assessed the predictors of the HbA1c reduction of ≥1% and/or the weight reduction of ≥3% as recommended by the Catalan Health Service. In 2854 patients who initiated a GLP-1RA during 2014 and 2015, the overall mean HbA1c values were reduced from the baseline by −0.84% (SD = 1.66) (−9.2 mmol/mol) and lost on average 2.73 kg (SD = 6.2). About 44% percent of patients decreased their HbA1c by ≥1%; 44% decreased their weight by ≥3%; and only 22% met both of them together. The odds of achieving a reduction of ≥1% in initial HbA1c were two-fold higher for patients with higher baseline levels, and the likelihood of a reduction of ≥3% in the initial weight was associated with a higher BMI at the baseline, but they were independent of each other. The composite outcome (target 1% HbA1c reduction and 3% weight loss) to evaluate both the GLP-1RA clinical benefit and treatment withdrawal should be judged from a patient-centered approach.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia

Franch-Nadal

Mata-Cases

Ortega

et al. 2019

JCM

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“…Baseline BMI as a predictor of the efficacy of glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA) treatment in lowering HbA1c is not fully characterized . In real‐world settings, analyses suggest that baseline BMI does not modify the efficacy of liraglutide treatment in patients with type 2 diabetes . In these studies, mean baseline BMI was reported to be 35.6 and 37.1 kg/m 2 .…”

Section: Introductionmentioning

confidence: 99%

“…1 In real-world settings, analyses suggest that baseline BMI does not modify the efficacy of liraglutide treatment in patients with type 2 diabetes. 2,3 In these studies, mean baseline BMI was reported to be 35. 6 and 37.1 kg/m 2 .…”

Section: Introductionmentioning

confidence: 99%

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

Gentilella

Sesti

Vazquez

et al. 2019

Diabetes Obesity Metabolism

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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.

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Immediate Impact of Switching from Dipeptidyl Peptidase 4 (DPP4) Inhibitors to Low-Dose (0.3 mg) Liraglutide on Glucose Profiles: A Retrospective Observational Study

Terui,

Igari,

Tsuno

et al. 2024

Diabetes Ther

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Introduction As treatment agents for diabetes, liraglutide is a long-acting glucagon-like peptide 1 receptor agonist, and dipeptidyl peptidase 4 (DPP4) inhibitors are widely used because of their safety and tolerability. Regular treatment with liraglutide has been reported to significantly reduce blood glucose levels, but the impact of low-dose (0.3 mg) liraglutide on blood glucose levels immediately after treatment switching from a DPP4 inhibitor remains unknown. Methods We conducted a single-arm, retrospective, observational study in 55 inpatients with type 2 diabetes (T2D) to investigate the changes (Δ) in their blood glucose levels at six time points (6-point) from the day before (day −1) to the day after (day 1) by switching the antidiabetic treatment from a DPP4 inhibitor to liraglutide 0.3 mg (low-dose liraglutide) once daily. We also attempted to identify factors associated with the blood glucose-lowering effects of liraglutide. Results The median values of the changes in fasting, preprandial, and postprandial blood glucose levels and the fluctuations in the blood glucose levels expressed as the standard deviation of the 6-point blood glucose levels were significantly lower on day 1 than on day −1 ( P < 0.05, P < 0.0001, P < 0.0001, P < 0.01, respectively); there were no cases of severe hypoglycemia. The Δ blood glucose levels were not associated with the baseline serum hemoglobin A1c values or with any markers of the insulin secreting capacity. There were no associations between the previously used blood glucose-lowering drug and the Δ blood glucose levels. Conclusion Switching from a DPP4 inhibitor to low-dose (0.3 mg) liraglutide once daily significantly reduced the blood glucose levels and excursions of the blood glucose levels even from the very day after the treatment switch, with no serious adverse events.

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Predictors of treatment response to liraglutide in type 2 diabetes in a real-world setting

Cited by 19 publications

References 21 publications

Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia

Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia

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

Immediate Impact of Switching from Dipeptidyl Peptidase 4 (DPP4) Inhibitors to Low-Dose (0.3 mg) Liraglutide on Glucose Profiles: A Retrospective Observational Study

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