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Once-Daily Liraglutide Versus Lixisenatide as Add-on to Metformin in Type 2 Diabetes: A 26-Week Randomized Controlled Clinical Trial.
Diabetes Care. 2016 Sep; 39(9):1501-9.DC

Abstract

OBJECTIVE

To compare the efficacy and safety of liraglutide versus lixisenatide as add-on to metformin in patients with type 2 diabetes not achieving adequate glycemic control on metformin alone.

RESEARCH DESIGN AND METHODS

In this 26-week, randomized, parallel-group, open-label trial, 404 patients were randomized 1:1 to liraglutide 1.8 mg or lixisenatide 20 µg as add-on to metformin. Liraglutide was administered once daily at any time of the day. Lixisenatide was administered once daily within 1 h prior to the morning or evening meal.

RESULTS

At week 26, liraglutide reduced HbA1c (primary end point) more than lixisenatide (estimated treatment difference -0.62% [95% CI -0.8; -0.4]; P < 0.0001), with more patients reaching HbA1c <7% (53 mmol/mol) and ≤6.5% (48 mmol/mol) versus lixisenatide (74.2% and 54.6% for liraglutide vs. 45.5% and 26.2% for lixisenatide; P < 0.0001 for both). Liraglutide reduced fasting plasma glucose more than lixisenatide (estimated treatment difference -1.15 mmol/L [95% CI -1.5; -0.8]; P < 0.0001). Liraglutide provided greater reduction in mean 9-point self-measured plasma glucose (P < 0.0001). However, postprandial glucose increments were smaller with lixisenatide for the meal directly after injection compared with liraglutide (P < 0.05), with no differences between treatments across all meals. Both drugs promoted similar body weight decrease (-4.3 kg for liraglutide, -3.7 kg for lixisenatide; P = 0.23). The most common adverse events in both groups were gastrointestinal disorders. Greater increases in pulse, lipase, and amylase were observed with liraglutide. Hypoglycemic episodes were rare and similar between the two treatments.

CONCLUSIONS

At the dose levels studied, liraglutide was more effective than lixisenatide as add-on to metformin in improving glycemic control. Body weight reductions were similar. Both treatments were well tolerated, with low risk of hypoglycemia and similar gastrointestinal adverse event profiles.

Authors+Show Affiliations

Division of Diabetology, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany michael.nauck@rub.de.Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.Department of Diabetes and Endocrinology, Southmead Hospital, Bristol, U.K.Novo Nordisk A/S, Søborg, Denmark.Novo Nordisk A/S, Søborg, Denmark.Department of Endocrinology, l'Institut du Thorax, Nantes University Hospital, Nantes, France.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27311491

Citation

Nauck, Michael, et al. "Once-Daily Liraglutide Versus Lixisenatide as Add-on to Metformin in Type 2 Diabetes: a 26-Week Randomized Controlled Clinical Trial." Diabetes Care, vol. 39, no. 9, 2016, pp. 1501-9.
Nauck M, Rizzo M, Johnson A, et al. Once-Daily Liraglutide Versus Lixisenatide as Add-on to Metformin in Type 2 Diabetes: A 26-Week Randomized Controlled Clinical Trial. Diabetes Care. 2016;39(9):1501-9.
Nauck, M., Rizzo, M., Johnson, A., Bosch-Traberg, H., Madsen, J., & Cariou, B. (2016). Once-Daily Liraglutide Versus Lixisenatide as Add-on to Metformin in Type 2 Diabetes: A 26-Week Randomized Controlled Clinical Trial. Diabetes Care, 39(9), 1501-9. https://doi.org/10.2337/dc15-2479
Nauck M, et al. Once-Daily Liraglutide Versus Lixisenatide as Add-on to Metformin in Type 2 Diabetes: a 26-Week Randomized Controlled Clinical Trial. Diabetes Care. 2016;39(9):1501-9. PubMed PMID: 27311491.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Once-Daily Liraglutide Versus Lixisenatide as Add-on to Metformin in Type 2 Diabetes: A 26-Week Randomized Controlled Clinical Trial. AU - Nauck,Michael, AU - Rizzo,Manfredi, AU - Johnson,Andrew, AU - Bosch-Traberg,Heidrun, AU - Madsen,Jesper, AU - Cariou,Bertrand, Y1 - 2016/06/16/ PY - 2015/11/18/received PY - 2016/05/21/accepted PY - 2016/6/18/entrez PY - 2016/6/18/pubmed PY - 2017/10/25/medline SP - 1501 EP - 9 JF - Diabetes care JO - Diabetes Care VL - 39 IS - 9 N2 - OBJECTIVE: To compare the efficacy and safety of liraglutide versus lixisenatide as add-on to metformin in patients with type 2 diabetes not achieving adequate glycemic control on metformin alone. RESEARCH DESIGN AND METHODS: In this 26-week, randomized, parallel-group, open-label trial, 404 patients were randomized 1:1 to liraglutide 1.8 mg or lixisenatide 20 µg as add-on to metformin. Liraglutide was administered once daily at any time of the day. Lixisenatide was administered once daily within 1 h prior to the morning or evening meal. RESULTS: At week 26, liraglutide reduced HbA1c (primary end point) more than lixisenatide (estimated treatment difference -0.62% [95% CI -0.8; -0.4]; P < 0.0001), with more patients reaching HbA1c <7% (53 mmol/mol) and ≤6.5% (48 mmol/mol) versus lixisenatide (74.2% and 54.6% for liraglutide vs. 45.5% and 26.2% for lixisenatide; P < 0.0001 for both). Liraglutide reduced fasting plasma glucose more than lixisenatide (estimated treatment difference -1.15 mmol/L [95% CI -1.5; -0.8]; P < 0.0001). Liraglutide provided greater reduction in mean 9-point self-measured plasma glucose (P < 0.0001). However, postprandial glucose increments were smaller with lixisenatide for the meal directly after injection compared with liraglutide (P < 0.05), with no differences between treatments across all meals. Both drugs promoted similar body weight decrease (-4.3 kg for liraglutide, -3.7 kg for lixisenatide; P = 0.23). The most common adverse events in both groups were gastrointestinal disorders. Greater increases in pulse, lipase, and amylase were observed with liraglutide. Hypoglycemic episodes were rare and similar between the two treatments. CONCLUSIONS: At the dose levels studied, liraglutide was more effective than lixisenatide as add-on to metformin in improving glycemic control. Body weight reductions were similar. Both treatments were well tolerated, with low risk of hypoglycemia and similar gastrointestinal adverse event profiles. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/27311491/Once_Daily_Liraglutide_Versus_Lixisenatide_as_Add_on_to_Metformin_in_Type_2_Diabetes:_A_26_Week_Randomized_Controlled_Clinical_Trial_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=27311491 DB - PRIME DP - Unbound Medicine ER -