Glucagon-like peptide-1 receptor agonists Exenatide ( Byetta ) and Liraglutide ( Victoza ) have been shown to improve glycaemic control and reduce bodyweight in patients with type 2 diabetes.
The efficacy and safety of Exenatide once weekly ( Bydureon ) with Liraglutide once daily in patients with type 2 diabetes mellitus, were compared.
Researchers did a 26 week, open-label, randomised, parallel-group study ( DURATION-6 ) at 105 sites in 19 countries during the period 2010-2011.
Patients aged 18 years or older with type 2 diabetes mellitus treated with lifestyle modification and oral antihyperglycaemic drugs were randomly assigned ( 1:1 ) to receive injections of once-daily Liraglutide ( 1.8 mg ) or once-weekly Exenatide ( 2 mg ). Participants and investigators were not masked to treatment assignment.
The primary endpoint was change in glycated haemoglobin ( HbA1c ) from baseline to week 26. Analysis was by intention to treat.
Of 912 randomised patients, 911 were included in the intention-to-treat analysis ( 450 Liraglutide, 461 Exenatide ). The least-squares mean change in HbA1c was greater in patients in the Liraglutide group ( -1.48%; n=386 ) than in those in the Exenatide group ( -1.28%; n=390 ) with the treatment difference ( 0.21% ) not meeting predefined non-inferiority criteria ( upper limit of CI less 0.25% ).
The most common adverse events were nausea ( 93 [ 21% ] in the Liraglutide group vs 43 [ 9% ] in the Exenatide group ), diarrhoea ( 59 [ 13% ] vs 28 [ 6% ] ), and vomiting 48 [ 11% ] vs 17 [ 4% ] ), which occurred less frequently in the Exenatide group and with decreasing incidence over time in both groups.
24 ( 5% ) patients allocated to Liraglutide and 12 ( 3% ) allocated to Exenatide discontinued participation because of adverse events.
Both once daily Liraglutide and once weekly Exenatide led to improvements in glycaemic control, with greater reductions noted with Liraglutide.
These findings, plus differences in injection frequency and tolerability, could inform therapeutic decisions for treatment of patients with type 2 diabetes mellitus. ( Xagena )
Buse JB et al, The Lancet 2013; 381: 117-124