01.12.2015 – 19:01
Victoza® (liraglutide) provides greater glycaemic control than SGLT-2 inhibitors
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New findings from a network meta-analysis show that treatment with Victoza® (liraglutide) provides a greater HbA1c reduction and an improved likelihood of reaching glycaemic goals compared to sodium-glucose co-transporter 2 (SGLT-2) inhibitors in people with type 2 diabetes who are inadequately controlled with metformin alone or in combination with sulfonylurea, dipeptidyl peptidase-4 (DPP-4) inhibitors or thiazolidinedione. Findings were presented today at the World Diabetes Congress of the International Diabetes Federation (IDF) in Vancouver, Canada.
The meta-analysis evaluated the relative efficacy of Victoza® to SGLT-2 inhibitors, including canagliflozin, empagliflozin and dapagliflozin. In an analysis of 17 randomised controlled trials (RCTs), Victoza® demonstrated greater reductions in mean HbA1c compared to all SGLT-2 inhibitors (placebo-adjusted mean change -1.01%/-1.18% for Victoza® 1.2 mg/1.8 mg; -0.64%/-0.79% for canagliflozin 100 mg/300 mg; -0.32%/-0.38% for dapagliflozin 5 mg/10 mg; -0.59%/-0.62% for empagliflozin 10 mg/25 mg).
"In the absence of head-to-head trials, this analysis provides valuable insight into the comparative outcomes with liraglutide versus SGLT-2 inhibitors in people with type 2 diabetes uncontrolled on oral antidiabetic treatments," said Maria Lorenzi, MSc, lead author and research manager, Redwood Outcomes, CA, US.
The networks of evidence analysed to evaluate the relative efficacy of Victoza® compared with approved SGLT-2 inhibitors were based on available data from RCTs that were published when the meta-analysis was initiated.
In network meta-analyses (NMA), multiple treatments are included, using data from trials that compare at least two of these treatments. A NMA offers the advantage of being able to compare any treatments included in the network, including those that have not been compared directly, and, in the right circumstances, allows the full set of treatments to be ranked. As with any NMA, some of the indirect comparisons in the Victoza® compared to SGLT-2 inhibitors NMA may be biased due to differences in patient characteristics between trials, most notably duration of diabetes, and the number of concomitant oral antidiabetic drugs.
Victoza® (liraglutide) is a human glucagon-like peptide-1 (GLP-1) analogue with an amino acid sequence 97% similar to endogenous human GLP-1. Like natural GLP-1, Victoza® works by stimulating the beta-cells to release insulin and suppressing glucagon secretion from the alpha cells only when blood sugar levels are high. Due to this glucose-dependent mechanism of action, Victoza® is associated with a low rate of hypoglycaemia.* In addition, Victoza® reduces body weight and body fat mass through mechanisms involving reduced appetite and lowered energy intake.
Victoza® was launched in the EU in 2009 and is commercially available in more than 80 countries with more than three million patient years of use in people with type 2 diabetes globally., In Europe, Victoza® is indicated for treatment of adults with type 2 diabetes to achieve glycaemic control in combination with oral glucose-lowering medicinal products and/or basal insulin when these, together with diet and exercise, do not provide adequate glycaemic control.
*Hypoglycaemia has primarily been observed when Victoza®is combined with a sulfonylurea or basal insulin.
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1. Lorenzi M, Ploug U, Langer J, et al. Liraglutide vs SGLT-2 inhibitors in people with type 2 diabetes: a network meta-analysis. Presented at 23rd World Diabetes Congress, Vancouver, BC, Canada; 30 November - 4 December 2015. Abstract number 0226-P. 2. Jackson D, Barrett J, Rice S, et al. A design-by-treatment interaction model for network meta-analysis with random inconsistency effects. Stat Med. 2014; 33:3639-3654. 3. EMA. Victoza® EU Summary of Product Characteristics. Available at: http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Produc t_Information/human/001026/WC500050017.pdf Last accessed October 2015. 4. Internal Calculations based on IMS Midas Quantum data. September 2015.
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