Exenatide is an incretin mimetic that shares glucoregulatory properties with glucagon-like peptide 1 (GLP- 1), and improves glycaemic control, with progressive bodyweight reductions, when administered twice a day in patients with type 2 diabetes. The researchers from Canada and the US compared the efficacy of a once-weekly formulation of exenatide to that of a twice daily dose. A 30-week, randomised, non-inferiority study compared a long-acting release formulation of exenatide 2 mg administered once weekly to 10 microg exenatide administered twice a day, in 295 patients with type 2 diabetes, mean HbA1c 8.3%, fasting plasma glucose 9 mmol/L, weight 102 kg, diabetes duration 6-7 years. The patients were naive to drug therapy, or on one or more oral antidiabetic agents. The primary endpoint was the change in HbA1c at 30 weeks.
At 30 weeks, the patients given exenatide once a week had significantly greater changes in HbA1c than those given exenatide twice a day. A significantly greater proportion of patients receiving treatment once a week versus twice a day achieved target HbA1c levels of 7.0% or less (77% vs 61% of evaluable patients).
The researchers concluded: "Exenatide once weekly resulted in significantly greater improvements in glycaemic control than exenatide given twice a day, with no increased risk of hypoglycaemia and similar reductions in bodyweight."
Sounds great, but how does it compare to current insulin regimens?
For the full abstract, click here.
The Lancet 372(9645):1240-1250, 4 October 2008 © 2008 Elsevier Ltd
Exenatide once weekly versus twice daily for the treatment of type 2 diabetes: a randomised, open-label, non- inferiority study. Dr Daniel J Drucker, John B Buse, Kristin Taylor et al for the DURATION-1 Study Group. Correspondence to Daniel J Drucker: d.drucker@utoronto.ca
Category: T. Endocrine/Metabolic/Nutritional. Keywords: exenatide, treatment, diabetes, randomised open label non inferiority study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 16 July 2010
