Endocrine Abstracts

Introduction: Once-daily liraglutide and once-weekly dulaglutide, both glucagón-like peptide-1 receptor agonists, improve glycemic control and reduce weight in patients with type 2 diabetes mellitus (T2DM) with a similar efficacy according to head-to-head trial AWARD-6. Nevertheless, there is a lack of evidence in a real-world setting. The focus of our study is to assess changes in glycemic control and weight resulting from switching from liraglutide to dulaglutide in patients with T2DM from baseline to week 24 in a real-world cohort of patients.

Methods/Design: Observational and retrospective study carried out in T2DM poorly controlled patients in routine clinical practice. Variables used to assess efficacy were changes in HbA1c, fasting plasma glucose (FPG) and weight from switching to week 24. Changes in antidiabetic drugs for maintaining adequate glycemic control were also recorded. Continuous variables are presented as mean and standard deviation or as a median and interquartile range based on data distribution. Categorical variables are presented as frequencies.

Results: Data from 26 patients (55.5% women; age: 57.4 ± 11.6 years; HbA1c: 7.1 [6.2–8.4]%; duration of T2DM: 12.6 ± 8.7 years) were collected. Failure to achieve metabolic and/or weight targets with liraglutide was the main cause for switching. At week 24, a non-significant reduction of HbA1c (–0.33%; P = 0.09) and a non-significant increase in weight (+2.53 Kg; P = 0.25) were observed. FPG was significantly reduced in the whole cohort (–22.3 mg/dl; P = 0.022) but the difference was non-significant when only patients on insulin, were analyzed. Patients on insulin also, required more insulin units for their glycemic control at week 24 (0.16 IU/kg [0.13–0.17] vs 0.53 IU/kg [0.29–0.93]; P < 0.0001). Treatment intensification was required in 26.9% of subjects at week 24.

Conclusions: In patients with long-duration T2DM and obesity, switching from once-daily liraglutide to once-weekly dulaglutide doesn’t result in beneficial effects in improvement of glycemic control or weight reduction at week 24. Our results, in a real-world setting, are consistent with a previous clinical trial, showing non-inferiority between both treatments. In our experience, there is no efficacy data to recommend switching.