September 28, 2017
1 min read

Once-weekly exenatide effectively lowers HbA1c

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Carol Wysham
Carol H. Wysham

Adults with type 2 diabetes assigned to the once-weekly GLP-1 receptor agonist exenatide experienced greater reductions in HbA1c than those assigned to twice-daily exenatide, but similar weight loss was observed, according to findings published in Diabetes, Obesity and Metabolism.

Carol H. Wysham, MD, section head of the Rockwood Center for Diabetes and Endocrinology at the Rockwood Clinic in Spokane, Washington, and colleagues evaluated data from DURATION-NEO-1 on adults with type 2 diabetes (baseline HbA1c, 8.5%) randomly assigned to once-weekly exenatide (2 mg; n = 229; Bydureon, AstraZeneca) or twice-daily exenatide (10 µg; n = 146; Byetta, AstraZeneca) for 28 weeks to compare the safety and efficacy of each dose.

HbA1c decreased with each dosage, but more so with the once-weekly dose (–1.39%) than the twice-daily dose (–1.02%). After 28 weeks, the decrease in HbA1c was greater with the once-weekly dose (difference, –0.37%; P = .0072) than the twice-daily dose.

The change in fasting plasma glucose at 28 weeks was also greater with the once-weekly dose than the twice-daily dose (difference, –10.2 mg/dL; P = .083). Fasting insulin concentrations (difference, 4.3 pmol/L; P = .11) and fasting glucagon concentrations (difference, 0.6 pmol/L; P = .89) both increased more with the once-weekly dose compared with the twice-daily dose.

At 28 weeks, no difference was observed for change in body weight between the two groups.

The most common adverse events were gastrointestinal and occurred more in the twice-daily group (35.6%) than the once-weekly group (22.7%).

According to the researchers, the longer-acting doses “have been administered with reduced injection frequency or with simpler injection devices to improve ease of use and patient satisfaction.” – by Amber Cox

Disclosures: Wysham reports she receives research support and serves as a consultant, adviser and speaker for AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Novo Nordisk and Sanofi. The study was funded by AstraZeneca and Bristol-Myers Squibb. Please see the study for all other authors’ relevant financial disclosures.