Using a new formulation of the diabetes drug exenatide given once weekly provides better blood sugar (glycaemic) control and is much more convenient than the current twice-daily regimen. These are the conclusions of an Article published early Online and in an upcoming edition of The Lancet, authored by Dr Daniel Drucker, Mount Sinai Hospital and University of Toronto, Ontario, Canada, and colleagues. The findings are being announced at The European Association for the Study of Diabetes meeting in Rome.
Exenatide improves blood sugar control and gives progressive weight reductions in patients with type 2 diabetes. In this randomised trial, 259 patients completed a 30-week course of either a long-acting release formulation of exenatide 2mg administered once weekly (129 patients), or 10µg exenatide twice a day (130 patients). The patients had a mean weight of 102kg and an average diabetes duration of nearly seven years. The extent of their blood sugar control was monitored by the levels of haemoglobin A1c*(HbA1c) in their blood, which was at a mean of 8.3% before exenatide was given.
The researchers found that patients given exenatide once weekly saw their HbA1c levels fall to a mean of 6.4% (-1.9%), while those given the drug twice daily only fell to 6.8% (-1.5%). More patients given the once weekly formulation (77%) achieved the target HbA1c of 7.0% or less compared with the twice daily regimen (61%); the proportions achieving HbA1c of 6.5% or less or 6.0% or less were similar in both groups. The authors conclude: "Exenatide once weekly resulted in significantly greater improvements in glycaemic control than exetanide given twice a day, with no increased risk of hypoglycaemia and similar reductions in bodyweight."
In an accompanying Comment. Dr André Scheen, University of Liège, Belgium says "Compared with the twice-a-day exenatide regimen, the once-a-week formulation, besides obvious improved ease of use, provided the remarkable advantage of both improved efficacy on glucose control and good gastrointestinal tolerability." He further suggests that management of type 2 diabetes could change substantially as after confirmation and extension of these findings.
*Note to editors: Glycosylated haemoglobin (HbA1c ) is a form of haemoglobin used primarily to identify the average plasma glucose concentration over prolonged periods of time. The HbA1c level is proportional to average blood glucose concentration over the previous four weeks to three months. Levels in healthy people are generally between 4.0% and 6.0%.
Dr Daniel Drucker, Mount Sinai Hospital and University of Toronto, Ontario, Canada T) will be at the European Association for the Study of Diabetes meeting in Rome; to contact Dr. Drucker please use email at d.drucker@utoronto.ca
Dr André Scheen, University of Liège, Belgium T) +32-4-3667238 E) andre.scheen@chu.ulg.ac.be
Full paper: http://press.thelancet.com/exenatidefinal.pdf
Journal
The Lancet