Efficacy and safety of switching from sitagliptin to liraglutide in subjects with type 2 diabetes (LIRA‐SWITCH): a randomized, double‐blind, double‐dummy, active‐controlled 26‐week trial. Issue 12 (14th September 2016)

• Record Type: Journal Article
• Authors: Bailey, T. S.; Takács, R.; Tinahones, F. J.; Rao, P. V.; Tsoukas, G. M.; Thomsen, A. B.; Kaltoft, M. S.; Maislos, M.
• Is Part Of: Diabetes, obesity & metabolism. Volume 18:Issue 12(2016)
• Page Start: 1191
• Page End: 1198
• Publication Date: 2016-09-14
• Subjects: liraglutide -- sitagliptin -- type 2 diabetes -- GLP-1 receptor agonist; Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.12736
• Languages: English
• ISSNs: 1462-8902

Abstract

Abstract : Aims: To confirm superiority on glycaemic control by switching from sitagliptin to liraglutide 1.8 mg/d versus continued sitagliptin. Materials and methods: A randomized, multicentre, double‐blind, double‐dummy, active‐controlled trial across 86 office‐ or hospital‐based sites in North America, Europe and Asia. Subjects with type 2 diabetes who had inadequate glycaemic control (glycated haemoglobin [HbA1c] 7.5−9.5% on sitagliptin (100 mg/d) and metformin (≥1500 mg daily) for ≥90 days were randomized to either switch to liraglutide (n = 203) or continue sitagliptin (n = 204), both with metformin. The primary endpoint was change in HbA1c from baseline to week 26. Change in body weight was a confirmatory secondary endpoint. Results: Greater reduction in mean HbA1c was achieved with liraglutide than with continued sitagliptin [−1.14% vs. −0.54%; estimated mean treatment difference (ETD): −0.61% (95% CI −0.82 to −0.40; p < 0.0001)], confirming superiority of switching to liraglutide. Body weight was reduced more with liraglutide [−3.31 kg vs. −1.64 kg; ETD: −1.67 kg (95% CI −2.34 to −0.99; p < 0.0001)]. Nausea was more common with liraglutide [44 subjects (21.8%)] than with continued sitagliptin [16 (7.8%)]. Three subjects (1.5%) taking sitagliptin reported a confirmed hypoglycaemic episode. Conclusions: Subjects insufficiently controlled with sitagliptin who switch to liraglutide can obtain clinically relevant reductions in glycaemia and body weight, without compromising safety. A switch from sitagliptin to liraglutide provides an option for improved management of type 2 diabetes while still allowing patients to remain on dual therapy.