A network meta-analysis to compare glycaemic control in patients with type 2 diabetes treated with exenatide once weekly or liraglutide once daily in comparison with insulin glargine, exenatide twice daily or placebo
A network meta-analysis to compare glycaemic control in patients with type 2 diabetes treated with exenatide once weekly or liraglutide once daily in comparison with insulin glargine, exenatide twice daily or placebo
AIMS: The glucagon-like peptide-1 receptor agonists (GLP-1 RAs) exenatide once weekly (ExQW) and liraglutide once daily (QD) are indicated to improve glycaemic control in patients with type 2 diabetes. Although glycaemic control with ExQW versus liraglutide QD 1.8 mg has been directly compared, no studies have compared ExQW with liraglutide QD 1.2 mg or determined the probable relative efficacies of various injectable therapies for glycaemic control; therefore, a network meta-analysis was performed to address these questions.
METHODS: A systematic review identified randomized controlled trials of ≥24 weeks that compared ExQW, liraglutide QD (1.2 mg, 1.8 mg), insulin glargine, exenatide twice daily (ExBID), or placebo. Twenty-two studies evaluating 11 049 patients were included in the network meta-analysis. Mean differences in HbA1c relative to placebo or each other and probability rankings were estimated.
RESULTS: Estimated mean differences in HbA1c versus placebo were -1.15% (95% CrI: -1.31 to -1.00) for ExQW, -1.01% (95% CrI: -1.18 to -0.85) for liraglutide 1.2 mg, and -1.18% (95% CrI: -1.32 to -1.04) for liraglutide 1.8 mg. HbA1c differences for ExQW versus liraglutide 1.2 mg and 1.8 mg were -0.14% (95% CrI: -0.34 to 0.06) and 0.03% (95% CrI: -0.14 to 0.18), respectively. The estimated mean difference in HbA1c between liraglutide 1.2 mg and 1.8 mg was 0.17% (95% CrI: 0.02-0.30). Results were consistent when adjusted for background antihyperglycaemic medications and diabetes duration.
CONCLUSIONS: This network meta-analysis did not identify meaningful differences in HbA1c lowering between ExQW and both liraglutide doses, suggesting that these GLP-1 RAs have similar glycaemic effects.
Blood Glucose/drug effects, Diabetes Mellitus, Type 2/blood, Drug Administration Schedule, Exenatide, Female, Glucagon-Like Peptide 1/administration & dosage, Glycated Hemoglobin A/drug effects, Humans, Hypoglycemic Agents/administration & dosage, Insulin Glargine, Insulin, Long-Acting/administration & dosage, Liraglutide, Male, Peptides/administration & dosage, Treatment Outcome, Venoms/administration & dosage
213-23
Scott, D.A.
19b5fd34-9974-4ae4-8be0-27a693639e20
Boye, K.S.
f8681527-092a-48be-a83f-fb55a7a3218d
Timlin, L.
1caf4840-6468-458f-bbd7-f0796cbb4213
Clark, J.F.
f765c701-13f8-415f-acb3-6faf2dc2004c
Best, J.H.
82319e65-081f-4f40-a79e-b356497222aa
March 2013
Scott, D.A.
19b5fd34-9974-4ae4-8be0-27a693639e20
Boye, K.S.
f8681527-092a-48be-a83f-fb55a7a3218d
Timlin, L.
1caf4840-6468-458f-bbd7-f0796cbb4213
Clark, J.F.
f765c701-13f8-415f-acb3-6faf2dc2004c
Best, J.H.
82319e65-081f-4f40-a79e-b356497222aa
Scott, D.A., Boye, K.S., Timlin, L., Clark, J.F. and Best, J.H.
(2013)
A network meta-analysis to compare glycaemic control in patients with type 2 diabetes treated with exenatide once weekly or liraglutide once daily in comparison with insulin glargine, exenatide twice daily or placebo.
Diabetes, Obesity and Metabolism, 15 (3), .
(doi:10.1111/dom.12007).
Abstract
AIMS: The glucagon-like peptide-1 receptor agonists (GLP-1 RAs) exenatide once weekly (ExQW) and liraglutide once daily (QD) are indicated to improve glycaemic control in patients with type 2 diabetes. Although glycaemic control with ExQW versus liraglutide QD 1.8 mg has been directly compared, no studies have compared ExQW with liraglutide QD 1.2 mg or determined the probable relative efficacies of various injectable therapies for glycaemic control; therefore, a network meta-analysis was performed to address these questions.
METHODS: A systematic review identified randomized controlled trials of ≥24 weeks that compared ExQW, liraglutide QD (1.2 mg, 1.8 mg), insulin glargine, exenatide twice daily (ExBID), or placebo. Twenty-two studies evaluating 11 049 patients were included in the network meta-analysis. Mean differences in HbA1c relative to placebo or each other and probability rankings were estimated.
RESULTS: Estimated mean differences in HbA1c versus placebo were -1.15% (95% CrI: -1.31 to -1.00) for ExQW, -1.01% (95% CrI: -1.18 to -0.85) for liraglutide 1.2 mg, and -1.18% (95% CrI: -1.32 to -1.04) for liraglutide 1.8 mg. HbA1c differences for ExQW versus liraglutide 1.2 mg and 1.8 mg were -0.14% (95% CrI: -0.34 to 0.06) and 0.03% (95% CrI: -0.14 to 0.18), respectively. The estimated mean difference in HbA1c between liraglutide 1.2 mg and 1.8 mg was 0.17% (95% CrI: 0.02-0.30). Results were consistent when adjusted for background antihyperglycaemic medications and diabetes duration.
CONCLUSIONS: This network meta-analysis did not identify meaningful differences in HbA1c lowering between ExQW and both liraglutide doses, suggesting that these GLP-1 RAs have similar glycaemic effects.
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More information
Published date: March 2013
Keywords:
Blood Glucose/drug effects, Diabetes Mellitus, Type 2/blood, Drug Administration Schedule, Exenatide, Female, Glucagon-Like Peptide 1/administration & dosage, Glycated Hemoglobin A/drug effects, Humans, Hypoglycemic Agents/administration & dosage, Insulin Glargine, Insulin, Long-Acting/administration & dosage, Liraglutide, Male, Peptides/administration & dosage, Treatment Outcome, Venoms/administration & dosage
Identifiers
Local EPrints ID: 442203
URI: http://eprints.soton.ac.uk/id/eprint/442203
ISSN: 1462-8902
PURE UUID: fe28ec85-969c-4644-8e97-b3a5e7fd1e0b
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Date deposited: 08 Jul 2020 16:39
Last modified: 17 Mar 2024 04:02
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Contributors
Author:
D.A. Scott
Author:
K.S. Boye
Author:
L. Timlin
Author:
J.F. Clark
Author:
J.H. Best
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