Liraglutide addition to SGLT2 inhibitors intensifies type 2 diabetes treatment: Study
Delhi: Liraglutide (1.8 mg) seems to be an effective way to intensify the treatment of type 2 diabetes irrespective of BMI, HbA1c, insulin resistance, diabetes duration, and SGLT2i use duration, according to results from a post-hoc analysis of the LIRA-ADD2SGLT2i trial.
"For people with type 2 diabetes (T2D) and inadequate glycaemic control despite therapy with SGLT2is±metformin, liraglutide 1.8mg would provide an effective treatment intensification option, irrespective of HbA1c, BMI, diabetes duration, insulin resistance determined by HOMA-IR and SGLT2i use duration," the researchers reported in the journal Diabetes, Obesity and Metabolism.
The LIRA-ADD2SGLT2i trial has shown that in adults with T2D, liraglutide+sodium-glucose cotransporter-2 inhibitors (SGLT2is)±metformin significantly improved glycaemic control (not body weight) versus placebo. In this post-hoc analysis, Lawrence Blonde, Frank Riddick Diabetes Institute, New Orleans, LA, USA, and colleagues assessed whether baseline characteristics influenced these findings.
LIRA-ADD2SGLT2i is a placebo-controlled, double-blind, multinational trial, wherein participants were randomized in the ratio of 2:1 to receive liraglutide (≤1.8mg/day) or a placebo. Changes from baseline to week 26 in HbA1c, body weight and waist circumference (WC) stratified by HbA1c, body mass index (BMI), diabetes duration, duration of pre-trial SGLT2i use and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) were analyzed. These five baseline characteristics were divided into tertiles, and the treatment effect was evaluated using the trial product estimand.
The researchers analyzed data from all 303 participants.
Key findings of the study include:
- There was a significant interaction between baseline HbA1c tertiles (7.0−<7.6%; 7.6–8.1%; ≥8.2−9.5%) and glycaemic control at week 26, with the lowest HbA1c estimated treatment difference (ETD) observed in patients with lowest baseline HbA1c (−0.20%; −0.68%; −0.98%, respectively).
- There were no significant interactions in glycaemic control across baseline BMI, diabetes duration, insulin resistance determined by HOMA-IR or SGLT2i use duration.
- Across the five characteristics assessed, no significant interactions were found for body weight or WC changes from baseline.
"For individuals with T2D and inadequate glycaemic control despite therapy with SGLT2is±metformin, liraglutide 1.8mg would provide an effective treatment intensification option, irrespective of HbA1c, BMI, diabetes duration, insulin resistance determined by HOMA-IR and SGLT2i use duration," concluded the authors.
Reference:
The study titled, "Efficacy of liraglutide added to sodium-glucose cotransporter-2 inhibitors in type 2 diabetes, stratified by baseline characteristics: post-hoc analysis of LIRA-ADD2SGLT2i," is published in the journal Diabetes, Obesity and Metabolism.
DOI: https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14464
