Comparison of insulin glargine and liraglutide added to oral agents in patients with poorly controlled type 2 diabetes. Issue 2 (7th December 2014)

• Record Type: Journal Article
• Authors: D'Alessio, D.; Häring, H.‐U.; Charbonnel, B.; de Pablos‐Velasco, P.; Candelas, C.; Dain, M.‐P.; Vincent, M.; Pilorget, V.; Yki‐Järvinen, H.; on behalf of the EAGLE Investigators
• Is Part Of: Diabetes, obesity & metabolism. Volume 17:Issue 2(2015:Feb.)
• Page Start: 170
• Page End: 178
• Publication Date: 2014-12-07
• Subjects: Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.12406
• Languages: English
• ISSNs: 1462-8902

Abstract

<abstract abstract-type="main" id="dom12406-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="dom12406-sec-0001" sec-type="section"> <title>Aim</title> <p id="dom12406-para-0001">To compare safety and efficacy of insulin glargine and liraglutide in patients with type 2 diabetes (T2DM).</p> </sec> <sec id="dom12406-sec-0002" sec-type="section"> <title>Methods</title> <p id="dom12406-para-0002">This randomized, multinational, open‐label trial included subjects treated for T2DM with metformin ± sulphonylurea, who had glycated haemoglobin (HbA1c) levels of 7.5–12%. Subjects were assigned to 24 weeks of insulin glargine, titrated to target fasting plasma glucose of 4.0–5.5 mmol/L or liraglutide, escalated to the highest approved clinical dose of 1.8 mg daily. The trial was powered to detect superiority of glargine over liraglutide in percentage of people reaching HbA1c <7%.</p> </sec> <sec id="dom12406-sec-0003" sec-type="section"> <title>Results</title> <p id="dom12406-para-0003">The mean [standard deviation (s.d.)] age of the participants was 57 (9) years, the duration of diabetes was 9 (6) years, body mass index was 31.9 (4.2) kg/m<sup>2</sup> and HbA1c level was 9.0 (1.1)%. Equal numbers (<italic>n</italic> = 489) were allocated to glargine and liraglutide. Similar numbers of subjects in both groups attained an HbA1c level of <7% (48.4 vs. 45.9%); therefore, superiority of glargine over liraglutide was not observed (p = 0.44). Subjects treated with glargine had greater reductions of HbA1c [−1.94% (0.05) and −1.79% (0.05); p = 0.019] and fasting plasma glucose [6.2 (1.6) and 7.9 (2.2) mmol/L; p < 0.001] than those receiving liraglutide. The liraglutide group reported a greater number of gastrointestinal treatment‐emergent adverse events (p < 0.001). The mean (s.d.) weight change was +2.0 (4.0) kg for glargine and −3.0 (3.6) kg for liraglutide (p < 0.001). Symptomatic hypoglycaemia was more common with glargine (p < 0.001). A greater number of subjects in the liraglutide arm withdrew as a result of adverse events (p < 0.001).</p> </sec> <sec id="dom12406-sec-0004" sec-type="section"> <title>Conclusion</title> <p id="dom12406-para-0004">Adding either insulin glargine or liraglutide to subjects with poorly controlled T2DM reduces HbA1c substantially, with nearly half of subjects reaching target levels of 7%.</p> </sec> </abstract>