Predictors of liraglutide response in clinical practice reported
medwireNews: Factors including bodyweight and treatment duration predict response to liraglutide in patients with type 2 diabetes treated in clinical practice, report researchers.
Of note, responses to liraglutide varied over time, with glycated hemoglobin (HbA1c) reaching its lowest point after 12 months of treatment, before rising again, and bodyweight continuing to fall until around 18 months.
The average starting HbA1c level of the 799 study participants prescribed liraglutide at one of six Spanish centers was 68 mmol/mol (8.4%). This fell to 53 mmol/mol (7.0%) after 3 months of treatment and to 52 mmol/mol (6.9%) after 12 months, but it then rose again, to approximately (58 mmol/mol (7.5%), during the subsequent 12 months of treatment.
Fernando Gomez‐Peralta (Segovia General Hospital, Spain) and co-researchers note that most randomized controlled trials (RCTs) and real-world studies report outcomes at 26 and 52 weeks, making theirs “one of the few reporting the evolution of clinical outcomes over a period of more than 12 months.”
The study participants were an average age of 56 years, with an average diabetes duration of 9 years, and a median follow-up duration of 7 months. A total of 35% were using insulin, and the researchers found that these patients had a significantly poorer HbA1c response to liraglutide than non-insulin users.
However, they believe this to be related to cautious insulin management because of concerns about the risk for hypoglycemia with concomitant liraglutide therapy, “rather than to an antagonistic effect between both treatments.”
Longer duration of insulin treatment also predicted a poorer HbA1c response, as did diabetes duration and higher baseline HbA1c, the team reports in Diabetic Medicine. Conversely, longer time of liraglutide treatment predicted a better HbA1c response and also predicted a better weight loss response.
Bodyweight started at an average of 104.4 kg, in keeping with local regulations allowing liraglutide only for people with a BMI greater than 30 kg/m2. It fell to around 95 kg by 12 months, and to 94 kg by 18 months, after which it remained stable.
Higher baseline bodyweight also predicted a better weight loss response, as did ongoing treatment with metformin.
“Importantly, the results obtained in this study are in agreement with those obtained in other RCTs, strengthening the reproducibility and the main conclusions highlighted,” conclude the researchers.
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