Both once-daily liraglutide and once-weekly exenatide afforded patients with type 2 diabetes improvements in glycemic control and weight loss in the recent randomized, open-label DURATION-6 study.
From January 2010 to January 2011, John B. Buse, MD, of the University of North Carolina School of Medicine, and colleagues conducted a 26-week, open-label, randomized, parallel-group study at 105 sites in 19 countries. Patients included in the study (n=911) were aged at least 18 years and had type 2 diabetes that was treated with lifestyle modification and oral antihyperglycemic drugs. They were randomly assigned to injections of 1.8 mg once-daily liraglutide (n=450; Victoza, Novo Nordisk) or 2 mg once-weekly exenatide (n=461; Bydureon, Amylin Pharmaceuticals).
John B. Buse
The primary endpoint was change in HbA1c from baseline to 26 weeks.
Compared with the exenatide group, patients in the liraglutide group had a greater least-squares mean change in HbA1c (–1.28% vs. –1.48%). However, the treatment difference (0.21%; 95% CI, 0.08-0.33) did not meet the predefined noninferiority criteria.
Progressive decreases in body weight were also seen with both drugs, although patients assigned to liraglutide lost more weight than those assigned to exenatide, regardless of BMI. Fasting serum glucose was significantly decreased in both groups at 26 weeks (P<.0001).
Patients in the exenatide group experienced less frequent adverse events, including nausea (21% in the liraglutide group vs. 9% in the exenatide group); diarrhea (13% in the liraglutide group vs. 6% in the exenatide group); and vomiting (11% in the liraglutide group vs. 4% in the exenatide group). These occurred less often over time in both groups, the researchers reported. Adverse events caused 5% of patients in the liraglutide group and 3% of patients in the exenatide group to discontinue participation.
In an accompanying editorial, Tina Thethi, MD, MPH, of Southeast Louisiana Veterans Health Care System, and Vivian Fonseca, MD, of Tulane University Health Sciences Center, said results of DURATION-6 could help clinicians make treatment decisions based on the relative efficacy and short-term side effects of both drugs.
“We look forward to more comparative trials that will help to drive clinical decision making in diabetes,” they wrote.
Disclosure: The study was funded by Eli Lilly and Amylin Pharmaceuticals. See the study for a full list of financial disclosures.