| Safety, efficacy and tolerability of exenatide in combination with insulin in the Association of British Clinical Diabetologists (ABCD) nationwide exenatide audit. | |
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MedLine Citation:
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PMID: 21410858 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Aim To assess the extent, safety, efficacy and tolerability of reported off-licence exenatide use through a nationwide audit. Methods ABCD hosted a password-protected, online collection of anonymised data of exenatide use in real clinical practice. 315 contributors from 126 centres across United Kingdom provided data on 6717 patients. HbA1c and weight changes, exenatide discontinuation, adverse events and treatment satisfaction were compared between non-insulin and insulin-treated patients. Results 4857 patients had baseline and follow-up treatment status with mean(±SD) baseline HbA1c 9.45±1.69% and BMI 40.0±8.2 kg/m(2) . 1921/4857 (39.6%) used exenatide with insulin. Comparing patients who continued insulin with exenatide with non-insulin-treated patients, mean(±SE) latest HbA1c and weight reduction (median 26 weeks) were 0.51±0.06% v 0.94±0.04% (p<0.001), and 5.8±0.2 kg v 5.5±0.1 kg (p=0.278). Insulin-treated patients had higher rates of exenatide discontinuation (31.0% v 13.9%, p<0.001), hypoglycaemia (8.9% v 6.1%, p<0.001), gastrointestinal side effects (28.4% v 25.0%, p=0.008) and treatment dissatisfaction (20.8% v 5.7%, p<0.001). However, 34.2% of patients continuing insulin still achieved HbA1c reduction ≥1%. There was significant insulin discontinuation, dose reduction and greater sulphonylurea discontinuation among insulin-treated patients. Conclusions Addition of exenatide to obese, insulin-treated patients can improve glycaemia and weight. Adverse events were statistically but probably not clinically significantly higher, but combination treatment was less well tolerated. Overall, exenatide was less effective in lowering HbA1c among insulin-treated patients although significant number of insulin-treated patients still achieved significant HbA1c, weight and insulin reduction. Further research into identifying obese, insulin-treated patients who will tolerate and benefit from exenatide treatment is urgently needed. |
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Authors:
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K Y Thong; B Jose; N Sukumar; M L Cull; A P Mills; T Sathyapalan; W Shafiq; A S Rigby; C Walton; R E J Ryder |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-16 |
Journal Detail:
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Title: Diabetes, obesity & metabolism Volume: - ISSN: 1463-1326 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883645 Medline TA: Diabetes Obes Metab Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 Blackwell Publishing Ltd. |
Affiliation:
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Department of Diabetes, City Hospital, Birmingham, United Kingdom Department of Diabetes, Hull Royal Infirmary, Hull, United Kingdom. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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