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Diabetes Obes Metab. 2016 Dec;18(12):1191-1198. doi: 10.1111/dom.12736. Epub 2016 Sep 14.

Efficacy and safety of switching from sitagliptin to liraglutide in subjects with type 2 diabetes (LIRA-SWITCH): a randomized, double-blind, double-dummy, active-controlled 26-week trial.

Author information

1
AMCR Institute, Escondido, California, USA.
2
First Department of Medicine, University of Szeged, Szeged, Hungary.
3
Department of Clinical Endocrinology and Nutrition, IBIMA, Hospital Virgen de la Victoria, CIBERobn, Instituto de Salud Carlos III, University of Málaga, Málaga, Spain.
4
Kumudini Devi Diabetes Research Center, Ramdevrao Hospital, Hyderabad, Telangana, India.
5
Department of Endocrinology and Metabolism, McGill University Health Centre, Montreal, Canada.
6
Global Development, Medical and Science, GLP-1 and Obesity, Novo Nordisk A/S, Søborg, Denmark.
7
Atherosclerosis and Metabolism Unit, Soroka UMC, Ben-Gurion University FOHS, Be'er Sheva, Israel.

Abstract

AIMS:

To confirm superiority on glycaemic control by switching from sitagliptin to liraglutide 1.8 mg/d versus continued sitagliptin.

MATERIALS AND METHODS:

A randomized, multicentre, double-blind, double-dummy, active-controlled trial across 86 office- or hospital-based sites in North America, Europe and Asia. Subjects with type 2 diabetes who had inadequate glycaemic control (glycated haemoglobin [HbA1c] 7.5-9.5% on sitagliptin (100 mg/d) and metformin (≥1500 mg daily) for ≥90 days were randomized to either switch to liraglutide (n = 203) or continue sitagliptin (n = 204), both with metformin. The primary endpoint was change in HbA1c from baseline to week 26. Change in body weight was a confirmatory secondary endpoint.

RESULTS:

Greater reduction in mean HbA1c was achieved with liraglutide than with continued sitagliptin [-1.14% vs. -0.54%; estimated mean treatment difference (ETD): -0.61% (95% CI -0.82 to -0.40; p < 0.0001)], confirming superiority of switching to liraglutide. Body weight was reduced more with liraglutide [-3.31 kg vs. -1.64 kg; ETD: -1.67 kg (95% CI -2.34 to -0.99; p < 0.0001)]. Nausea was more common with liraglutide [44 subjects (21.8%)] than with continued sitagliptin [16 (7.8%)]. Three subjects (1.5%) taking sitagliptin reported a confirmed hypoglycaemic episode.

CONCLUSIONS:

Subjects insufficiently controlled with sitagliptin who switch to liraglutide can obtain clinically relevant reductions in glycaemia and body weight, without compromising safety. A switch from sitagliptin to liraglutide provides an option for improved management of type 2 diabetes while still allowing patients to remain on dual therapy.

KEYWORDS:

GLP-1 receptor agonist; liraglutide; sitagliptin; type 2 diabetes

PMID:
27381275
PMCID:
PMC5129465
DOI:
10.1111/dom.12736
[Indexed for MEDLINE]
Free PMC Article

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