Effectiveness of Liraglutide in Type 2 Diabetes Patients Switched from a DPP-4 Inhibitor: 1-Year Data from EVIDENCE®

Abstract

Here we assess the effectiveness of 1 year’s treatment with liraglutide in patients with type 2 diabetes who switched from a DPP-4 inhibitor (DPP-4i) in EVIDENCE® study; a multicentre, observational, post-marketing outpatient study requested by the French National Health Authority to evaluate the effectiveness and safety of liraglutide. Objective: to determine percentage patients still taking liraglutide and at A1C target (<7%) after 2 years. Of 3137 patients enrolled, 1255 (40%) were receiving a DPP-4i prior to liraglutide initiation. Thirty-two percent (n=1004) switched to liraglutide at study start, while 8% (n=251) added liraglutide to a DPP-4i. Patients who switched and continued liraglutide for 1 year (n=734) achieved significant reductions from baseline in mean A1C (–0.84%, p<0.0001), fasting plasma glucose (–0.27g/L, p<0.0001) and weight (–3.53kg, p<0.0001). More subjects had A1C<7% at 1 year (31.6%) vs. baseline (8.0%; p<0.0001). Withdrawals (30% overall) were mostly due to gastrointestinal disorders experienced early in the study. In conclusion, significant reductions in glycemic control and weight were observed after 1 year of liraglutide treatment in patients who switched from a DPP-4i at study start. Lack of a control arm makes it difficult to evaluate whether observed improvements are attributable to liraglutide alone. Switching from the DPP-4i sitagliptin to liraglutide in a randomized controlled trial (Pratley et al. 2012) provided significant A1C (–0.5%; p<0.0001) and body weight reductions (–2.5 kg; p<0.0001). EVIDENCE® is more representative of routine practice; results reported here may be more indicative of real-world liraglutide treatment outcomes.TableBaseline characteristics of patients switching from a DPP-4i to liraglutideBaseline characteristicsn1004Age, years58 ± 10Diabetes duration, years9.8 ± 6.3A1C, %8.5 ± 1.4Patients with A1C <7%, %8%Fasting plasma glucose, g/L1.8 ± 0.6Weight, kg95 ± 18BMI, kg/m234 ± 6Data are mean ± SD. Open table in a new tab Data are mean ± SD.