In the August issue of Lancet, The LEAD-6 trial has been published which had compared Liraglutide and exenatide in patients with inadequately controlled type 2 diabetes on maximally tolerated doses of metformin, sulphonylurea, or both.
It was found that Liraglutide reduced mean HbA1c significantly more than did exenatide (−1·12% [SE 0·08] vs −0·79% [0·08]; estimated treatment difference −0·33; 95% CI −0·47 to −0·18; p<0·0001) and more patients achieved a HbA1c value of less than 7% (54% vs 43%, respectively; odds ratio 2·02; 95% CI 1·31 to 3·11; p=0·0015).
Liraglutide reduced mean fasting plasma glucose more than did exenatide (−1·61 mmol/L [SE 0·20] vs −0·60 mmol/L [0·20]; estimated treatment difference −1·01 mmol/L; 95% CI −1·37 to −0·65; p<0·0001) but postprandial glucose control was less effective after breakfast and dinner.
Both drugs promoted similar weight losses (liraglutide −3·24 kg vs exenatide −2·87 kg).
Both drugs were well tolerated, but nausea was less persistent (estimated treatment rate ratio 0·448, p<0·0001) and minor hypoglycaemia less frequent with liraglutide than with exenatide (1·93 vs 2·60 events per patient per year; rate ratio 0·55; 95% CI 0·34 to 0·88; p=0·0131; 25·5% vs 33·6% had minor hypoglycaemia).
The authors concluded that Liraglutide once a day provided significantly greater improvements in glycaemic control than did exenatide twice a day, and was generally better tolerated.
The results suggest that liraglutide might be a treatment option for type 2 diabetes, especially when weight loss and risk of hypoglycaemia are major considerations.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60659-0/fulltext?_eventId=login&elsca1=PPV-TL-AUGUST&elsca2=email&elsca3=segment#
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