Combo Therapy Improves Weight, A1c in Patients with Poorly Controlled Diabetes
Adding once-weekly exenatide (ExQW) to titrated insulin glargine (IG) therapy could help patients with type 2 diabetes and hyperglycemia achieve hemoglobin A1c (HbA1c) control and reduce their body weight, according to the findings of a recent study.
In their post-hoc analysis, the researchers assessed data from 464 patients with type 2 diabetes and hyperglycemia who were involved in the DURATION-7 trial. In the trial, 233 patients were randomly assigned to receive ExQW or placebo with or without metformin while receiving titrated IG for 28 weeks.
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A total of 461 participants (91%) completed the trial. The mean age of participants was 57.7 years, mean diabetes duration was 11.3 years, mean HbA1c was 8.5%, mean body weight was 94 kg, mean body mass index was 33.7 kg/m2, and mean IG dose was 51 U per day.
A greater proportion of patients who received ExQW and IG achieved HbA1c reductions after 28 weeks compared with patients who received placebo and IG (81% [165 out of 204] vs 60% [123 out of 206], respectively). Additionally, only 39 patients (19%) who received ExQW experienced increases in HbA1c compared with 83 patients (40%) who received placebo.
ExQW and IG was associated with greater losses in body weight compared with placebo and IG (127 patients [62%] vs 82 patients [40%], respectively), with only 77 patients (28%) who received ExQW experiencing increases in weight compared with 124 patients (60%) who received placebo.
Overall, 103 patients (51%) who received EQW and IG achieved both body weight reduction and HbA1c, which was more than double the number of patients who achieved both in the placebo group (47 [23%]).
“While patients with inadequately controlled [type 2 diabetes] despite optimized IG ± metformin, demonstrated a wide range of HbA1c and body weight responses with ExQW or placebo addition to ongoing titrated IG, patients receiving ExQW were twice as likely to experience an improvement in HbA1c and body weight reductions than those remaining on titrated IG alone,” the researchers concluded.
—Melissa Weiss
Reference:
Hardy E, Rosenstock J, Frías JP, et al. Individual HbA1c and weight responses to exenatide QW or placebo added to titrated insulin glargine in type 2 diabetes uncontrolled after insulin optimisation in the DURATION-7 study. Presented at: European Association for the Study of Diabetes 53rd Annual Meeting September 12-15; Lisbon, ES. http://www.abstractsonline.com/pp8/#!/4294/presentation/5555.