New Diabetes Medication May Offer Better Heart Protection

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WASHINGTON DC—Liraglutide, an experimental once-daily, injectable drug treatment for type 2 diabetes, may reduce cholesterol and other risk factors for heart disease better than other currently available diabetes medications, according to a meta-analysis.

Researchers say improvements in lipid levels might be either a result of weight loss or improved metabolism in general. Compared with patients taking other diabetes drugs, liraglutide was associated with significantly greater reductions in the proportion of patients with metabolic syndrome, investigators reported here at the Endocrine Society's 91st Annual Meeting.

“Pooled results from studies in nearly 4,000 patients with type 2 diabetes show that liraglutide controls blood sugar very effectively, but that it can also reduce weight, cholesterol, and other risk factors for heart disease that are more common in diabetic patients,” said lead investigator Richard Pratley, MD, Professor of Medicine at the University of Vermont College of Medicine in Burlington.

Dr. Pratley and his colleagues reviewed six previously published phase 3 clinical trials that were part of the Liraglutide Effect and Action in Diabetes study. The study compared liraglutide with glimepiride, rosiglitazone, injectable exenatide, and injectable insulin glargine. The researchers wanted to find out if 26 weeks of treatment with liraglutide could reduce the frequency of the metabolic syndrome.

Metabolic syndrome was defined according to criteria established by the National Cholesterol Education Program's Adult Treatment Panel III. Patients had to have at least three of the following risk factors to have metabolic syndrome: high blood glucose, abdominal obesity with a waist circumference of greater than 40 inches in men and 35 inches in women, high LDL cholesterol, low HDL cholesterol, high triglycerides (150 mg or greater), and high BP (greater than 130/85 mm/Hg).

Liraglutide significantly reduced total cholesterol compared with rosiglitazone, insulin glargine, and placebo, with between-group differences of 16.3, 6.1, and 5.6 mg/dL. Liraglutide significantly reduced LDL cholesterol compared with rosiglitazone, glimepiride, and insulin glargine, with between-group differences of 10, 3.1, and 5.2 mg/dL.

For HDL cholesterol, the researchers found that rosiglitazone provided significantly greater improvements in HDL cholesterol than all of the other medications and placebo.

In a subset of patients who met criteria for metabolic syndrome at baseline, the researchers found that, at 26 weeks, liraglutide significantly decreased the odds of having metabolic syndrome by 41% compared with glimepiride, 51% compared with exenatide, and 37% compared with placebo.

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