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Is liraglutide a useful addition to diabetes therapy?
MedLine Citation:
PMID:  20439238     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate liraglutide as an antidiabetic agent.
METHODS: The pertinent English-language medical literature was reviewed for the period from 1985 to April 2010 with use of data from MEDLINE.
RESULTS: Liraglutide is a glucagonlike peptide-1 receptor analogue that stimulates insulin secretion, reduces postprandial glucagon release, causes a mild delay in gastric emptying, and may slightly decrease appetite. Mean reductions in hemoglobin A1c levels with liraglutide therapy range from 1.0% to 1.5% in comparison with baseline and are 1.0% and 1.3% in comparison with placebo. Head-to-head trials suggest that liraglutide may be more effective than glimepiride, rosiglitazone, insulin glargine, and exenatide. Some of the previous trials, however, are limited by use of submaximal doses of comparator drugs and an open-label design. The use of liraglutide is associated with a mean weight loss of 0.2 to 3.2 kg relative to baseline and 0.1 to 2.6 kg relative to placebo. Liraglutiderelated hypoglycemia is generally mild, but its incidence and severity substantially increase in conjunction with sulfonylureas. Gastrointestinal adverse effects such as nausea, diarrhea, or vomiting occurred in 44% to 56% of patients who received liraglutide versus 17% to 19% with placebo. Premature withdrawal from trials occurred in 4% to 15% of liraglutide-treated patients (mainly attributable to gastrointestinal adverse effects), in comparison with 3% to 5% of those receiving placebo.
CONCLUSION: The 2 main advantages of liraglutide are mild degrees of weight loss and hypoglycemia. Important limitations, however, are the frequent occurrence of gastrointestinal adverse effects, the requirement of subcutaneous injection once daily, and the lack of long-term efficacy and safety data. Liraglutide may be a useful add-on therapy in patients with type 2 diabetes uncontrolled with metformin, when hypoglycemia, weight gain, or both are major concerns.
Authors:
Nasser E Mikhail
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  16     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2011-01-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1028-37     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of California Medical Center, Sylmar, CA, USA. nmikhail@dhs.lacounty.gov
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