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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 after liraglutide introduction by difference in duration of diabetes: less than 10 years (n = 23) or over 10 years (n = 34). **P < 0.001, *P < 0.05 compared with the values at baseline.
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Figure 4: Changes in HbA1c (NGSP), 2 h postprandial plasma glucose for 24 weeks after liraglutide introduction by difference in duration of diabetes: less than 10 years (n = 23) or over 10 years (n = 34). **P < 0.001, *P < 0.05 compared with the values at baseline.

Mentions: The efficacy of liraglutide in patients by BMI is shown in Figure 3. Contrary to initial expectations, the greatest efficacy (2.5% decrease in HbA1c levels) was observed in non-obese patients with BMI < 25 kg/m2. Efficacy decreased as the degree of obesity increased to a BMI of 25 kg/m2 or greater, and even further with a BMI of 30 kg/m2 or greater. Liraglutide is generally effective in markedly obese patients. However, the results of the present study revealed that this agent is not effective in patients with severe obesity. Efficacy according to the duration of type 2 diabetes is shown in Figure 4. Efficacy was clearly higher in patients who had a short duration of diabetes, i.e. less than 10 years, as compared to those with durations exceeding 10 years. In addition, history of SU drug use was examined using the SU index, which was defined as the dose in milligrams converted to an equivalent regimen of glimepiride multiplied by the number of years it was administered. The results of the differential analysis performed to ascertain whether SU index scores were lower or higher than 5 are shown in Figure 5. In the group that clearly had low SU index scores, liraglutide was observed to be markedly effective.


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 after liraglutide introduction by difference in duration of diabetes: less than 10 years (n = 23) or over 10 years (n = 34). **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 4: Changes in HbA1c (NGSP), 2 h postprandial plasma glucose for 24 weeks after liraglutide introduction by difference in duration of diabetes: less than 10 years (n = 23) or over 10 years (n = 34). **P < 0.001, *P < 0.05 compared with the values at baseline.
Mentions: The efficacy of liraglutide in patients by BMI is shown in Figure 3. Contrary to initial expectations, the greatest efficacy (2.5% decrease in HbA1c levels) was observed in non-obese patients with BMI < 25 kg/m2. Efficacy decreased as the degree of obesity increased to a BMI of 25 kg/m2 or greater, and even further with a BMI of 30 kg/m2 or greater. Liraglutide is generally effective in markedly obese patients. However, the results of the present study revealed that this agent is not effective in patients with severe obesity. Efficacy according to the duration of type 2 diabetes is shown in Figure 4. Efficacy was clearly higher in patients who had a short duration of diabetes, i.e. less than 10 years, as compared to those with durations exceeding 10 years. In addition, history of SU drug use was examined using the SU index, which was defined as the dose in milligrams converted to an equivalent regimen of glimepiride multiplied by the number of years it was administered. The results of the differential analysis performed to ascertain whether SU index scores were lower or higher than 5 are shown in Figure 5. In the group that clearly had low SU index scores, liraglutide was observed to be markedly effective.

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