Clinical Outcomes Using Long-Term Combination Therapy With Insulin Glargine and Exenatide In Patients With Type 2 Diabetes
Endocrine Practice, 07/12/2011
Clinical Article
Levin PA et al. – Regardless of treatment order, long–term combined therapy with glargine and exenatide for up to 24 months in patients with inadequately controlled type 2 diabetes (T2D) suggests reduction of A1C without significant weight gain or increased hypoglycemia risk.
Methods- A 24–month retrospective US chart review conducted from patients with inadequately controlled type 2 diabetes (T2D) and A1C <7.0% for whom glargine and exenatide were co–prescribed in differing order (glargine added after exenatide [exenatide/glargine], n=44; exenatide added after glargine [glargine/exenatide], n=121); treatment order groups were combined to form a pooled treatment group.
- Changes from baseline in A1C, patients with A1C ≤7.0%, body weight, glargine/exenatide daily dose/weight, oral antidiabetic drug (OAD) use, and hypoglycemia were evaluated.
- Treatment groups were similar at baseline; however, glargine/exenatide (vs exenatide/glargine) had longer disease duration (11.8 vs 8.0 years) and took fewer OADs (1.7 vs 2.3).
- baseline A1C was 8.8% ± 1.3% and weight was 109.5 ± 25.3 kg.
- Statistically significant A1C reductions emerged at month 6 and persisted throughout 24 months (vs baseline) in both treatment groups (pooled: –0.7 ± 1.6; P<.0001) and 33.0% of patients achieved A1C ≤7.0%.
- After 24 months with exenatide/glargine, body weight remained unchanged (0.7 ± 8.3 kg; P=.6401).
- With glargine/exenatide, body weight decreased (–2.5 ± 6.7 kg; P=.0010).
- At month 24, daily glargine dose was 0.40 ± 0.23 units/kg for exenatide/glargine, and 0.47 ± 0.30 units/kg for glargine/exenatide.
- Hypoglycemia frequency was similar in both treatment groups.
