QW GLP-1 RAs: Impact on A1c and Weight

Studies reveal that continuous intravenous infusion of glucagon-like peptide-1 (GLP-1) over 24 hours consistently normalizes blood glucose and averts the peaks and valleys of twice-daily injection.There are 3 once-weekly GLP-1 receptor agonist formulations now available for patients with type 2 diabetes that provide this continuous exposure, reduce A1c by an average of 1.4%, and promote weight loss on average of 2-3 kg. As a class the QW GLP-1 RAs have been studied as monotherapy and in combination with a variety of oral antidiabetes drugs and with insulin. The slides above are a concise summary of the large body of research on:Exenatide     (Bydureon)    March 2014Albiglutide   (Tanzeum)    April 2014Dulaglutide  (Trulicity)     September 2014 Sources Bergenstal RM, Wysham C, Macconell L, et al. Efficacy and safety of exenatide once weekly versus sitagliptin or pioglitazone as an adjunct to metformin for treatment of type 2 diabetes (DURATION-2): a randomized trial. Lancet. 2010;376:431-439.Blonde L, Jendle J, Gross J, et al. Once-weekly dulaglutide versus bedtime insulin glargine, both in combination with prandial insulin lispro, in patients with type 2 diabetes (AWARD-4): a randomised, open-label, phase 3, non-inferiority study. Lancet. 2015;385:2057–2066. DOI: http://dx.doi.org/10.1016/S0140-6736(15)60936-9Diamant M, Van Gaal L, Stranks S, et al. Once weekly exenatide compared with insulin glargine titrated to target in patients with type 2 diabetes (DURATION-3): an open-label randomised trial. Lancet. 2010;375:2234-2243.Giorgino F, Benroubi M, Sun J-H, Zimmerman AG, Pechtner V. Efficacy and safety of once-weekly dulaglutide vs insulin glargine in combination with metformin and glimepiride in type 2 diabetes patients (AWARD-2). Presented at American Diabetes Association’s 74th Scientific Sessions June 13 - 17, 2014; San Francisco, CA. 330-OR). Russell-Jones D, Cuddihy RM, Hanefeld M, et al. Efficacy and safety of exenatide once weekly versus metformin, pioglitazone, and sitagliptin used as monotherapy in drug-naïve patients with type 2 diabetes (DURATION-4). Diabetes Care. 2015;35:252-258.TRULICITY™ [prescribing information]. Indianapolis, IN: Eli Lilly and Company;2014.BYDUREON™ [prescribing information]. San Diego, CA: Amylin Pharmaceuticals;2012.TANZEUM™ [prescribing information]. Wilmington, DE: GlaxoSmithKline;2014  Sources Russell-Jones D, Cuddihy RM, Hanefeld M, et al. Efficacy and safety of exenatide once weekly versus metformin, pioglitazone, and sitagliptin used as monotherapy in drug-naïve patients with type 2 diabetes (DURATION-4). Diabetes Care. 2015;35:252-258.Bergenstal RM, Wysham C, Macconell L, et al. Efficacy and safety of exenatide once weekly versus sitagliptin or pioglitazone as an adjunct to metformin for treatment of type 2 diabetes (DURATION-2): a randomized trial. Lancet. 2010;376:431-439.Diamant M, Van Gaal L, Stranks S, et al. Once weekly exenatide compared with insulin glargine titrated to target in patients with type 2 diabetes (DURATION-3): an open-label randomised trial. Lancet. 2010;375:2234-2243.TRULICITY™ [prescribing information]. Indianapolis, IN: Eli Lilly and Company;2014.BYDUREON™ [prescribing information]. San Diego, CA: Amylin Pharmaceuticals;2012.TANZEUM™ [prescribing information]. Wilmington, DE: GlaxoSmithKline;2014