Introduction: This study looked at the the safety and efficacy of switching a patient from twice-daily exenatide to once-daily liraglutide. This switch was compared to 40 weeks of continuous liraglutide therapy.
Methods: This was a 14-week extension of the Lifaglutide Effect and Action in Diabetes (LEAD-6) 26-week randomized trial. The LEAD-6 trial showed that liraglutide, when added to oral antidiabetes drugs, more effectively improved HbA1c, fasting plasma glucose, and the homeostasis model of beta-cell function than exenatide. Additionally, liraglutide didn't cause as persistent nausea and hypglycemia.
For this extension of the LEAD-6 trial, there were 2 groups: a group that switch from twice-daily exenatide at 10 mcg to once-daily liraglutide at 1.8 mg, and a group that continued liraglutide therapy. The extension was 14 weeks long.
Results: The patients who were on liraglutide for the full 40 weeks had the same HbA1c at the end of the 14-week extension. However, the ones who had switched from exenatide to liraglutide showed a further 0.32% reduction in HbA1c. In addition, a further reduction of weight (-0.9 kg) and fasting blood glucoses (-16 mg/dL) were noted in the group that changed to liraglutide.
Commentary by Grazia Aleppo MD, FACE, FACP
This study was chosen because it shows the persistent beneficial effect of once-daily liraglutide over 40 weeks in patients with uncontrolled type 2 diabetes in terms of HbA1c, weight loss, and fasting blood glucose reduction.
Furthermore, it shows beneficial effects in terms of additional weight loss, HbA1c reduction, lower fasting blood glucoses, and less gastrointestinal side effects when changing from twice-daily exenatide to once-daily liraglutide, with potential greater adherence to therapy in patients with diabetes.