Online first
Research paper
Published online: 2024-04-22

open access

Page views 39
Article views/downloads 53
Get Citation

Connect on Social Media

Connect on Social Media

Effectiveness and Safety of Add-on Once-Daily Liraglutide (1.2 mg) in Type 2 Diabetes Patients with Obesity: Data from a Real-World Cohort of Iraqi Patients

Haider Ayad Alidrisi1, Sameh Abed Odhaib2, Hussein Ali Nwayyir1, Ammar Mohammed Saeed Almomin3

Abstract

Objective: This study aimed to evaluate real-world effectiveness and safety of once-daily liraglutide (1.2 mg) as an add-on to oral antidiabetic drugs (OADs) and/or insulin, in type 2 diabetes (T2D) patients with obesity in Iraq. Materials and methods: A total of 55 T2D patients with obesity (mean ± SD age: 46.5 ± 8.7 years, 60% were females) initiating once-daily liraglutide (1.2 mg) as an add-on to OADs and/or insulin were included in this prospective cohort study. Change in body weight and serum HbA1c levels, and the insulin and sulfonylurea (SU) requirement were recorded during 24-week liraglutide therapy. Results: Liraglutide yielded significant reduction in HbA1c values (from 10.7 ± 2.0% at baseline to 8.7 ± 2.4 % and 8.1 ± 1.6 % at weeks 12 and 24, respectively, p < 0.001 for each) and body weight (from 112.0 ± 19.6 kg at baseline to 109 ± 19.1 kg, 102 ± 16.9 kg and 97.0 ± 15.8 kg at weeks 4, 12 and 24, respectively, p < 0.001 for each). SU was stopped in 9/17 (52.9%) patients, and insulin therapy was discontinued in 15/44 (34%) patients after liraglutide treatment, and either with discontinuation or switch to basal insulin, 22/34 (64.7%) patients were no longer
requiring prandial insulin (premixed and basal/bolus). No unexpected safety or tolerability issues occurred. Conclusions: In conclusion, our findings support the consideration of liraglutide as a favorable intensifying therapy in T2D patients with obesity and metformin failure, given that it enables a sustained HbA1c and body weight reduction even at 1.2 mg once-daily dose, alongside the potential benefits in reducing SU and insulin requirements with no serious side effects.

Article available in PDF format

View PDF Download PDF file

References

  1. Lazzaroni E, Ben Nasr M, Loretelli C, et al. Anti-diabetic drugs and weight loss in patients with type 2 diabetes. Pharmacol Res. 2021; 171: 105782.
  2. Evert AB, Franz MJ. Why Weight Loss Maintenance Is Difficult. Diabetes Spectr. 2017; 30(3): 153–156.
  3. Bailey CJ, Flatt PR, Conlon JM. An update on peptide-based therapies for type 2 diabetes and obesity. Peptides. 2023; 161: 170939.
  4. Iglay K, Hannachi H, Joseph Howie P, et al. Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus. Curr Med Res Opin. 2016; 32(7): 1243–1252.
  5. Davies MJ, D'Alessio DA, Fradkin J, et al. 30291106. Diabetes Care. 2018; 41(12): 2669–2701.
  6. American Diabetes Association. 9. Pharmacologic Approaches to Glycemic Treatment: . Diabetes Care. 2021; 44(Suppl 1): S111–S124.
  7. Davies MJ, Bergenstal R, Bode B, et al. NN8022-1922 Study Group. Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes: The SCALE Diabetes Randomized Clinical Trial. JAMA. 2015; 314(7): 687–699.
  8. Howell R, Wright AM, Clements JN. Clinical potential of liraglutide in cardiovascular risk reduction in patients with type 2 diabetes: evidence to date. Diabetes Metab Syndr Obes. 2019; 12: 505–512.
  9. Silva-Nunes J, Nascimento E, Louro J, et al. Liraglutide Effectiveness in Type 2 Diabetes: Insights from a Real-World Cohort of Portuguese Patients. Metabolites. 2022; 12(11).
  10. Zhou F, Jiang Lu, Guo J, et al. Degree of obesity and gastrointestinal adverse reactions influence the weight loss effect of liraglutide in overweight or obese patients with type 2 diabetes. Ther Adv Chronic Dis. 2023; 14: 20406223231161516.
  11. Rahmah A, Al-Isawi J, Mahdi O. The efficacy of once-daily liraglutide as an add-on to oral antidiabetic agents on weight reduction and glycemic control in obese patients with inadequately controlled type 2 diabetes: a retrospective analysis in relation to liraglutide dose escalation within a 7-month treatment period. International Journal of Diabetes in Developing Countries. 2020; 41(2): 266–272.
  12. Bashier AMK, Hussain AA, Abdelgadir EI, et al. Liraglutide effect in reducing HbA1c and weight in Arab population with type2 diabetes, a prospective observational trial. J Diabetes Metab Disord. 2015; 14: 48.
  13. Yousef CC, Thomas A, Matar MAl, et al. Liraglutide effects on glycemic control and weight in patients with type 2 diabetes Mellitus: A real-world, observational study and brief narrative review. Diabetes Res Clin Pract. 2021; 177: 108871.
  14. Ostawal A, Mocevic E, Kragh N, et al. Clinical Effectiveness of Liraglutide in Type 2 Diabetes Treatment in the Real-World Setting: A Systematic Literature Review. Diabetes Ther. 2016; 7(3): 411–438.
  15. Sethi BK, Viswanathan V, Kumar A, et al. Liraglutide in clinical practice: insights from LEAD programme. J Assoc Physicians India. 2010; 58: 18–22.
  16. Capehorn MS, Catarig AM, Furberg JK, et al. Efficacy and safety of once-weekly semaglutide 1.0mg vs once-daily liraglutide 1.2mg as add-on to 1-3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes Metab. 2020; 46(2): 100–109.
  17. Gu J, Meng X, Guo Y, et al. The efficacy and safety of liraglutide added to metformin in patients with diabetes: a meta-analysis of randomized controlled trials. Sci Rep. 2016; 6: 32714.
  18. Russell-Jones D, Khan R. Insulin-associated weight gain in diabetes--causes, effects and coping strategies. Diabetes Obes Metab. 2007; 9(6): 799–812.
  19. Zinman B, Gerich J, Buse JB, et al. LEAD-4 Study Investigators. Efficacy and safety of the human glucagon-like peptide-1 analog liraglutide in combination with metformin and thiazolidinedione in patients with type 2 diabetes (LEAD-4 Met+TZD). Diabetes Care. 2009; 32(7): 1224–1230.
  20. Russell-Jones D, Vaag A, Schmitz O, et al. Liraglutide Effect and Action in Diabetes 5 (LEAD-5) met+SU Study Group. Liraglutide vs insulin glargine and placebo in combination with metformin and sulfonylurea therapy in type 2 diabetes mellitus (LEAD-5 met+SU): a randomised controlled trial. Diabetologia. 2009; 52(10): 2046–2055.
  21. Nauck M, Frid A, Hermansen K, et al. LEAD-2 Study Group. Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin, in type 2 diabetes: the LEAD (liraglutide effect and action in diabetes)-2 study. Diabetes Care. 2009; 32(1): 84–90.
  22. Nauck MA, Quast DR, Wefers J, et al. GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art. Mol Metab. 2021; 46: 101102.
  23. Gough SCL, Bode B, Woo V, et al. NN9068-3697 (DUAL-I) trial investigators. Efficacy and safety of a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with its components given alone: results of a phase 3, open-label, randomised, 26-week, treat-to-target trial in insulin-naive patients with type 2 diabetes. Lancet Diabetes Endocrinol. 2014; 2(11): 885–893.
  24. Abusnana S, Al Awadi F, Aly H, et al. Switching to a fixed-ratio combination of insulin degludec/liraglutide (IDegLira) is associated with improved glycaemic control in a real-world population with type 2 diabetes mellitus in the United Arab Emirates: Results from the multicentre, prospective INTENSIFY study. Diabetes Res Clin Pract. 2023; 196: 110183.
  25. Garvey WT, Birkenfeld AL, Dicker D, et al. Efficacy and Safety of Liraglutide 3.0 mg in Individuals With Overweight or Obesity and Type 2 Diabetes Treated With Basal Insulin: The SCALE Insulin Randomized Controlled Trial. Diabetes Care. 2020; 43(5): 1085–1093.
  26. Martinka E, Dravecká I, Tkáč I. Switching from Multiple Insulin Injections to a Fixed Combination of Degludec and Liraglutide in Patients with Type 2 Diabetes Mellitus: Results from the Simplify Study After 6 Months. Diabetes Ther. 2023; 14(9): 1503–1515.
  27. Unger J, Allison DC, Kaltoft M, et al. LIRA-PRIME investigators. Maintenance of glycaemic control with liraglutide versus oral antidiabetic drugs as add-on therapies in patients with type 2 diabetes uncontrolled with metformin alone: A randomized clinical trial in primary care (LIRA-PRIME). Diabetes Obes Metab. 2022; 24(2): 204–211.
  28. Ciresi A, Vigneri E, Radellini S, et al. Liraglutide Improves Cardiovascular Risk as an Add-on to Metformin and Not to Insulin Secretagogues in Type 2 Diabetic Patients: A Real-life 48-Month Retrospective Study. Diabetes Ther. 2018; 9(1): 363–371.
  29. Simioni N, Berra C, Boemi M, et al. ReaL (NN2211-4118) Study Group*. Predictors of treatment response to liraglutide in type 2 diabetes in a real-world setting. Acta Diabetol. 2018; 55(6): 557–568.
  30. Wu H, Lu Z, Chen R, et al. Factors associated with gastrointestinal side effects after liraglutide treatment for type 2 diabetes. Front Endocrinol (Lausanne). 2023; 14: 1098032.