Long-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists

Hamish Courtney,1 Rahul Nayar,2 Chinnadorai Rajeswaran,3 Ravi Jandhyala 4 1Diabetes Department, Royal Victoria Hospital, Belfast, 2City Hospitals Sunderland NHS Foundation Trust, Sunderland, 3Department of Diabetes & Endocrinology, Mid Yorkshire NHS Trust, Dewsbury, 4Medical Affairs, Diabete...

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Autores principales:	Courtney H, Nayar R, Rajeswaran C, Jandhyala R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	albiglutide dulaglutide exenatide liraglutide lixisenatide long-term Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/8a308f75e3eb4afeaa8d08e68d6d2edc
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spelling	oai:doaj.org-article:8a308f75e3eb4afeaa8d08e68d6d2edc2021-12-02T06:51:16ZLong-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists1178-7007https://doaj.org/article/8a308f75e3eb4afeaa8d08e68d6d2edc2017-03-01T00:00:00Zhttps://www.dovepress.com/long-term-management-of-type-2-diabetes-with-glucagon-like-peptide-1-r-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Hamish Courtney,1 Rahul Nayar,2 Chinnadorai Rajeswaran,3 Ravi Jandhyala 4 1Diabetes Department, Royal Victoria Hospital, Belfast, 2City Hospitals Sunderland NHS Foundation Trust, Sunderland, 3Department of Diabetes & Endocrinology, Mid Yorkshire NHS Trust, Dewsbury, 4Medical Affairs, Diabetes, AstraZeneca, Luton, UK Abstract: Continuously reducing excess blood glucose is a primary goal for the management of type 2 diabetes (T2D). Most patients with T2D require glucose-lowering medications to achieve and maintain adequate glycemic control; however, treatment failure may occur, limiting treatment options. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are an emerging therapeutic class that can be prescribed for patients instead of basal insulin after the failure of oral therapies. Recent studies have focused on the durability and tolerability of long-term GLP-1RA therapy. This review summarizes the key efficacy and safety findings from prospective phase 3 clinical studies of at least 76 weeks’ duration for the GLP-1RAs currently approved in the United States and the European Union (albiglutide, dulaglutide, exenatide twice daily [BID], exenatide once weekly [QW], liraglutide, and lixisenatide). Currently, most of the long-term data are from uncontrolled extension studies, and continuous patient benefit has been observed for up to 3 years with multiple GLP-1RAs. Four-year comparative data demonstrated a longer time to treatment failure for exenatide BID than for sulfonylurea, and 3-year comparative extension data demonstrated greater glycated hemoglobin (HbA1c) reductions and weight loss with exenatide QW than with insulin glargine. Currently, the longest extension study for a GLP-1RA is the DURATION-1 study of exenatide QW, with >7 years of clinical data available. Data from DURATION-1 demonstrated that continuous HbA1c reductions and weight loss were observed for the patients continuing on the treatment, with no unexpected adverse events. Taken together, these data support GLP-1RAs as a long-term noninsulin treatment option after the failure of oral therapies. Keywords: albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, long-termCourtney HNayar RRajeswaran CJandhyala RDove Medical Pressarticlealbiglutidedulaglutideexenatideliraglutidelixisenatidelong-termSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 10, Pp 79-87 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	albiglutide dulaglutide exenatide liraglutide lixisenatide long-term Specialties of internal medicine RC581-951
spellingShingle	albiglutide dulaglutide exenatide liraglutide lixisenatide long-term Specialties of internal medicine RC581-951 Courtney H Nayar R Rajeswaran C Jandhyala R Long-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists
description	Hamish Courtney,1 Rahul Nayar,2 Chinnadorai Rajeswaran,3 Ravi Jandhyala 4 1Diabetes Department, Royal Victoria Hospital, Belfast, 2City Hospitals Sunderland NHS Foundation Trust, Sunderland, 3Department of Diabetes & Endocrinology, Mid Yorkshire NHS Trust, Dewsbury, 4Medical Affairs, Diabetes, AstraZeneca, Luton, UK Abstract: Continuously reducing excess blood glucose is a primary goal for the management of type 2 diabetes (T2D). Most patients with T2D require glucose-lowering medications to achieve and maintain adequate glycemic control; however, treatment failure may occur, limiting treatment options. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are an emerging therapeutic class that can be prescribed for patients instead of basal insulin after the failure of oral therapies. Recent studies have focused on the durability and tolerability of long-term GLP-1RA therapy. This review summarizes the key efficacy and safety findings from prospective phase 3 clinical studies of at least 76 weeks’ duration for the GLP-1RAs currently approved in the United States and the European Union (albiglutide, dulaglutide, exenatide twice daily [BID], exenatide once weekly [QW], liraglutide, and lixisenatide). Currently, most of the long-term data are from uncontrolled extension studies, and continuous patient benefit has been observed for up to 3 years with multiple GLP-1RAs. Four-year comparative data demonstrated a longer time to treatment failure for exenatide BID than for sulfonylurea, and 3-year comparative extension data demonstrated greater glycated hemoglobin (HbA1c) reductions and weight loss with exenatide QW than with insulin glargine. Currently, the longest extension study for a GLP-1RA is the DURATION-1 study of exenatide QW, with >7 years of clinical data available. Data from DURATION-1 demonstrated that continuous HbA1c reductions and weight loss were observed for the patients continuing on the treatment, with no unexpected adverse events. Taken together, these data support GLP-1RAs as a long-term noninsulin treatment option after the failure of oral therapies. Keywords: albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, long-term
format	article
author	Courtney H Nayar R Rajeswaran C Jandhyala R
author_facet	Courtney H Nayar R Rajeswaran C Jandhyala R
author_sort	Courtney H
title	Long-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists
title_short	Long-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists
title_full	Long-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists
title_fullStr	Long-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists
title_full_unstemmed	Long-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists
title_sort	long-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/8a308f75e3eb4afeaa8d08e68d6d2edc
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Long-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists

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