MedicalResearch.com Interview with:
Francesco Zaccardi, MD
Diabetes Research Centre
Leicester General Hospital,
Leicester, United Kingdom
Medical Research: What is the background for this study?
Dr. Zaccardi: Nowadays there are different classes of drugs for the treatment of hyperglycaemia in patients with type 2 diabetes and, within the same class, multiple drugs are available.Glucagon-like peptide-1 receptors (GLP-1RAs) are a relatively new class of treatments that improve glucose control and reduce body weight, without an increased risk for hypoglycaemia. To date, however, no direct comparisons between once-weekly GLP-1RAs have been reported. In this view, the aim was to assess the comparative efficacy and safety profile of GLP-1RAs using a network meta-analysis, a methodology that allows the estimation of the comparative effectiveness of multiple treatments in the absence of direct evidence.
Medical Research: What are the main findings?
Dr. Zaccardi: There are several differences in the efficacy and safety profiles of once-weekly glucagon-like peptide-1 receptor agonists (GLP-1RAs). Some of these drugs evidenced a better glucose control or body weight reduction, while other had an increased risk of side effects, such as nausea. Compared to other once-weekly GLP-1RAs, dulaglutide 1.5mg, once weekly exenatide, and taspoglutide 20mg showed a greater reduction of HbA1c, fasting plasma glucose, and body weight. Marginal or no differences were found for blood pressure and blood lipid levels. While taspoglutide 20mg had the highest risk of nausea, the risk of hypoglycaemia among once-weekly GLP-1RAs was comparable.
Medical Research: What should clinicians and patients take away from your report?
Dr. Zaccardi: Current ADA/EASD guidelines for the treatment of hyperglycaemia in type 2 diabetes advocate a `personalised’ approach taking into account patient’s characteristics and balancing potential risks and benefits of individual drugs. In this view, our findings could help clinicians to follow current ADA/EASD recommendations.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Zaccardi: Direct comparisons among these drugs are needed for a better comparative assessment. Moreover, long-term trials with vascular endpoints will clarify whether changes in intermediate biomarkers would also translate into a reduction in vascular complications.
Zaccardi F, Htike ZZ, Webb DR, Khunti K, Davies MJ. Benefits and Harms of Once-Weekly Glucagon-like Peptide-1 Receptor Agonist Treatments: A Systematic Review and Network Meta-analysis. Ann Intern Med. [Epub ahead of print 8 December 2015] doi:10.7326/M15-1432
Francesco Zaccardi, MD (2015). Once Weekly GLP-1RAs For Type 2 Diabetes have potential to Reduce Weight and Improve Glucose Control MedicalResearch.com