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Efficacy and Clinical Characteristics of Liraglutide in Japanese Patients With Type 2 Diabetes.

Ito D, Iuchi T, Kurihara S, Inoue I, Katayama S, Inukai K - J Clin Med Res (2015)

Bottom Line: Thus, efficacy decreased as the degree of obesity increased.As appetite suppressions and associated decreases in body weights were not observed in obese patients, the efficacy of liraglutide at 0.9 mg did not appear to be high.Rather, it appeared to be highly effective for patients who were non-obese and for whom amelioration of blood glucose elevations could be anticipated via the stimulation of insulin secretion.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan ; Division of Internal Medicine, Ogawa Red Cross Hospital, 1525, Ogawa, Ogawa, Hiki-gun, Saitama 355-0397, Japan.

ABSTRACT

Background: Liraglutide was first released in Japan as a long-acting once-daily glucagon-like peptide-1 receptor agonist. The maximum dose in Japan is 0.9 mg/day, which is half of that used in the United States and the European Union (1.8 mg/day). The efficacy of this maximum allowable dose of liraglutide for Japanese patients and the profiles of those patients for whom this agent should be recommended remain unclear.

Methods: This study aimed to examine the effective use of liraglutide in Japanese type 2 diabetic patients. We administered liraglutide to 60 patients, who had been managed with oral hypoglycemic agents or diet and exercise therapy only, during a period of 6 months.

Results: Though HbA1c levels significantly decreased, by approximately 1.5%, after 6 months of liraglutide administration, no significant changes in body weights were observed. The 0.6 mg dose was effective in approximately 40% of patients. In contrast, the effects of a dose increase from 0.6 mg to 0.9 mg were small. The greatest efficacy, as shown by a 2.5% HbA1c decrease, was achieved in non-obese patients. Thus, efficacy decreased as the degree of obesity increased. In addition, efficacy was higher in patients who had a diabetes duration of less than 10 years and was also higher in the group that had a low sulfonylurea (SU) index, when we define the SU index as mg/glimepiride × years of treatment.

Conclusions: As appetite suppressions and associated decreases in body weights were not observed in obese patients, the efficacy of liraglutide at 0.9 mg did not appear to be high. Rather, it appeared to be highly effective for patients who were non-obese and for whom amelioration of blood glucose elevations could be anticipated via the stimulation of insulin secretion. Therefore, we found that liraglutide at doses of 0.9 mg was highly effective in non-obese patients who were in the early stages of diabetes and was particularly effective in patients who had not yet been administered SU agents.

No MeSH data available.


Related in: MedlinePlus

Changes in HbA1c (NGSP), 2 h postprandial plasma glucose for 24 weeks by different liraglutide doses received: 0.6 mg (n = 22) or 0.9 mg (n = 35). **P < 0.001, *P < 0.05 compared with the values at baseline.
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Figure 2: Changes in HbA1c (NGSP), 2 h postprandial plasma glucose for 24 weeks by different liraglutide doses received: 0.6 mg (n = 22) or 0.9 mg (n = 35). **P < 0.001, *P < 0.05 compared with the values at baseline.

Mentions: Changes in HbA1c concentrations, postprandial blood glucose levels, and BMI values of all 57 patients are shown in Figure 1. Six months after starting liraglutide administration, marked decreases in mean HbA1c and postprandial plasma glucose levels were observed. In contrast, no significant changes in mean body weights were observed though there were temporary decreases in body weights at the time of initial liraglutide administration. The changes in final doses are shown in Figure 2. At the end of this study, 22 patients were still being treated with 0.6 mg, and 35 patients with 0.9 mg of liraglutide. It should be noted that the 0.6 mg dose was effective in approximately 40% of patients overall. While a marked decrease (3%) in HbA1c levels was observed in patients who received the 0.6 mg dose, only a small decrease (< 1% decrease in HbA1c levels) was observed in the group that received the higher 0.9 mg dose. Therefore, the 0.6 mg dose appeared to be sufficient in most Japanese patients for whom liraglutide was effective. However, increasing the dose to 0.9 mg did not necessarily lead to greater HbA1c reductions. Thus, from the viewpoint of cost effectiveness, it is recommended to first observe the courses of patients given the 0.6 mg dose and then increase the dose to 0.9 mg as required.


Efficacy and Clinical Characteristics of Liraglutide in Japanese Patients With Type 2 Diabetes.

Ito D, Iuchi T, Kurihara S, Inoue I, Katayama S, Inukai K - J Clin Med Res (2015)

Changes in HbA1c (NGSP), 2 h postprandial plasma glucose for 24 weeks by different liraglutide doses received: 0.6 mg (n = 22) or 0.9 mg (n = 35). **P < 0.001, *P < 0.05 compared with the values at baseline.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4522987&req=5

Figure 2: Changes in HbA1c (NGSP), 2 h postprandial plasma glucose for 24 weeks by different liraglutide doses received: 0.6 mg (n = 22) or 0.9 mg (n = 35). **P < 0.001, *P < 0.05 compared with the values at baseline.
Mentions: Changes in HbA1c concentrations, postprandial blood glucose levels, and BMI values of all 57 patients are shown in Figure 1. Six months after starting liraglutide administration, marked decreases in mean HbA1c and postprandial plasma glucose levels were observed. In contrast, no significant changes in mean body weights were observed though there were temporary decreases in body weights at the time of initial liraglutide administration. The changes in final doses are shown in Figure 2. At the end of this study, 22 patients were still being treated with 0.6 mg, and 35 patients with 0.9 mg of liraglutide. It should be noted that the 0.6 mg dose was effective in approximately 40% of patients overall. While a marked decrease (3%) in HbA1c levels was observed in patients who received the 0.6 mg dose, only a small decrease (< 1% decrease in HbA1c levels) was observed in the group that received the higher 0.9 mg dose. Therefore, the 0.6 mg dose appeared to be sufficient in most Japanese patients for whom liraglutide was effective. However, increasing the dose to 0.9 mg did not necessarily lead to greater HbA1c reductions. Thus, from the viewpoint of cost effectiveness, it is recommended to first observe the courses of patients given the 0.6 mg dose and then increase the dose to 0.9 mg as required.

Bottom Line: Thus, efficacy decreased as the degree of obesity increased.As appetite suppressions and associated decreases in body weights were not observed in obese patients, the efficacy of liraglutide at 0.9 mg did not appear to be high.Rather, it appeared to be highly effective for patients who were non-obese and for whom amelioration of blood glucose elevations could be anticipated via the stimulation of insulin secretion.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Diabetes, Saitama Medical University, 38, Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan ; Division of Internal Medicine, Ogawa Red Cross Hospital, 1525, Ogawa, Ogawa, Hiki-gun, Saitama 355-0397, Japan.

ABSTRACT

Background: Liraglutide was first released in Japan as a long-acting once-daily glucagon-like peptide-1 receptor agonist. The maximum dose in Japan is 0.9 mg/day, which is half of that used in the United States and the European Union (1.8 mg/day). The efficacy of this maximum allowable dose of liraglutide for Japanese patients and the profiles of those patients for whom this agent should be recommended remain unclear.

Methods: This study aimed to examine the effective use of liraglutide in Japanese type 2 diabetic patients. We administered liraglutide to 60 patients, who had been managed with oral hypoglycemic agents or diet and exercise therapy only, during a period of 6 months.

Results: Though HbA1c levels significantly decreased, by approximately 1.5%, after 6 months of liraglutide administration, no significant changes in body weights were observed. The 0.6 mg dose was effective in approximately 40% of patients. In contrast, the effects of a dose increase from 0.6 mg to 0.9 mg were small. The greatest efficacy, as shown by a 2.5% HbA1c decrease, was achieved in non-obese patients. Thus, efficacy decreased as the degree of obesity increased. In addition, efficacy was higher in patients who had a diabetes duration of less than 10 years and was also higher in the group that had a low sulfonylurea (SU) index, when we define the SU index as mg/glimepiride × years of treatment.

Conclusions: As appetite suppressions and associated decreases in body weights were not observed in obese patients, the efficacy of liraglutide at 0.9 mg did not appear to be high. Rather, it appeared to be highly effective for patients who were non-obese and for whom amelioration of blood glucose elevations could be anticipated via the stimulation of insulin secretion. Therefore, we found that liraglutide at doses of 0.9 mg was highly effective in non-obese patients who were in the early stages of diabetes and was particularly effective in patients who had not yet been administered SU agents.

No MeSH data available.


Related in: MedlinePlus