News Release

Liraglutide better than exenatide at controlling blood glucose in diabetes

And better tolerated (LEAD-6 study)

Peer-Reviewed Publication

The Lancet_DELETED

Liraglutide once daily is substantially better at controlling blood glucose in type 2 diabetes than is twice-daily exenatide (a currently marketed treatment). The findings of the LEAD-6 study are reported in an Article Online First and in an upcoming edition of the Lancet. The findings are also being presented at the American Diabetes Association meeting in New Orleans, USA.

Liraglutide and exenatide work by mimicking incretins—gut hormones produced after a meal that increase insulin production. In this randomised trial, Professor John Buse, University of North Carolina School of Medicine, Chapel Hill, NC, USA and colleagues studied 464 patients—all adults with inadequately controlled type 2 diabetes on maximally tolerated doses of the diabetes drugs metformin, sulphonylurea, or both. Of these, 233 received liraglutide 1.8 mg once daily, while 231 received exenatide 10 µg twice-daily. The primary outcome was the change in glycosylated haemoglobin (HbA1c)*.

Mean baseline HbA1c for the study population was 8.2%. Liraglutide reduced mean HbA1c by 1.12%, compared with a 0.79% reduction for patients on exenatide. More patients achieved an HbA1c level of less than 7.0% in the liraglutide group (54%) than in the exenatide group (43%). Liraglutide also reduced mean fasting blood glucose levels by around two-and-a-half times more than did exenatide. However, exenatide reduced blood glucose more than did liraglutide after breakfast and dinner meals, suggesting that liraglutide exerts more of its effects in the pre-meal or fasting period. Both drugs promoted similar weight loss (liraglutide -3.2kg vs exenatide -2.9kg). Both drugs were well tolerated, but nausea was less persistent and low blood sugar (hypoglycaemia) less common with liraglutide than with exenatide.

The authors conclude: "Liraglutide once-daily provided significantly greater improvements in glycaemic control than did exenatide twice a day, and was generally better tolerated. The results suggest that liraglutide might be a treatment option for type 2 diabetes, especially when weight loss and risk of hypoglycaemia are major considerations."

In an accompanying Comment, Dr Christophe De Block and Dr Luc Van Gaal, Antwerp University Hospital and University of Antwerp, Belgium, say: "The LEAD-6 trial shows that liraglutide provides greater improvements in glycaemic control and is better tolerated than exenatide; therefore, this [treatment] might be a good option for the treatment of type 2 diabetes."

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For Professor John Buse, University of North Carolina School of Medicine, Chapel Hill, NC, USA please contact Stephanie Crayton T) +1 919-966-2860 E) scrayton@unch.unc.edu

Dr Christophe De Block, Antwerp University Hospital and University of Antwerp, Belgium (at ADA) T) +32 477 207 991 E) christophe.deblock@ua.ac.be

For full Article and Comment, see: http://press.thelancet.com/lead6ada.pdf

Note to editors: *HbA1c is used to indicate the average plasma glucose concentration of the preceding two to three months. In general, the reference range (that found in healthy persons who do not have diabetes), is about 4%—5.9%. Patients with diabetes usually have HbA1c levels above 6.5%


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