Changing Lives with Next Generation Peptide Therapeutics
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Semaglutide Versus Liraglutide for Treatment of Obesity
Archives of Diabetes & Obesity DOI: 10.32474/ADO.2021.03.000162 ISSN: 2638-5910 Review Article Semaglutide versus liraglutide for treatment of obesity Nasser Mikhail* *Department of Medicine, Endocrinology Division, David-Geffen UCLA Medical School, USA *Corresponding author: Nasser Mikhail, Endocrinology Division, Department of Medicine, Olive View-UCLA Medical Center, David- Geffen UCLA Medical School, CA, USA Received: April 02, 2021 Published: April 19, 2021 Abstract Background: Once weekly (OW) semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) currently under evaluation for treatment of obesity at a dose of 2.4 mg OW. Objective Methods : To compare weight-loss efficacy and safety of once daily (OD) liraglutide 3.0 mg versus OW semaglutide 2.4 mg. : Pubmed research up to March 31, 2021. Randomized trials, pertinent animal studies, and reviews are included. Search Results terms were glucagon-like peptide-1 receptor agonists, weight loss, obesity, liraglutide, semaglutide, efficacy, safety. semaglutide 2.4 mg. However, marked resemblance between trials in terms of study protocols and subjects’ characteristics may allow indirect: No comparison. head to head In clinical trials are trials available of OW tosemaglutide, provide direct this comparison drug was consistently of efficacy ofassociated OD liraglutide with greater 3.0 mg weightversus lossOW than in trials of OD liraglutide. Thus, placebo-corrected percentage weight reduction was -10.3 to -12.4% and -5.4% with OW semaglutide and OD liraglutide, respectively. In patients with type 2 diabetes, corresponding weight reduction was less pronounced with both drugs being -6.2% and -4.3% with OW semaglutide and OD liraglutide, respectively. -
GLP-1 Receptor Agonists
Cognitive Vitality Reports® are reports written by neuroscientists at the Alzheimer’s Drug Discovery Foundation (ADDF). These scientific reports include analysis of drugs, drugs-in- development, drug targets, supplements, nutraceuticals, food/drink, non-pharmacologic interventions, and risk factors. Neuroscientists evaluate the potential benefit (or harm) for brain health, as well as for age-related health concerns that can affect brain health (e.g., cardiovascular diseases, cancers, diabetes/metabolic syndrome). In addition, these reports include evaluation of safety data, from clinical trials if available, and from preclinical models. GLP-1 Receptor Agonists Evidence Summary GLP-1 agonists are beneficial for patients with type 2 diabetes and obesity. Some evidence suggests benefits for Alzheimer’s disease. It is unclear whether it is beneficial for individuals without underlying metabolic disease. Semaglutide seems to be most effective for metabolic dysfunction, though liraglutide has more preclinical data for Alzheimer’s disease. Neuroprotective Benefit: Evidence from many preclinical studies and a pilot biomarker study suggest some neuroprotective benefits with GLP-1 agonists. However, whether they may be beneficial for everyone or only a subset of individuals (e.g. diabetics) is unclear. Aging and related health concerns: GLP-1 agonists are beneficial for treating diabetes and cardiovascular complications relating to diabetes. It is not clear whether they have beneficial effects in otherwise healthy individuals. Safety: GLP-1 agonists are generally safe for most people with minor side effects. However, long-term side effects are not known. 1 Availability: Available Dose: Varies - see Chemical formula: C172H265N43O51 (Liraglutide) as a prescription chart at the end of MW: 3751.262 g/mol medicine. -
Combining a Glucagon-Like Peptide-1 Receptor Agonist with Basal Insulin: the Why and How
Combining a Glucagon-like Peptide-1 Receptor Agonist with Basal Insulin: The Why and How Case Study Mary is a 61 year-old female diagnosed with type 2 diabetes mellitus (T2DM) 8 years ago. She was initially managed with the combination of lifestyle modification and metformin. Since that time she was treated with a sulfonylurea, but it was discontinued due to symptomatic hypoglycemia. She was also treated with pioglitazone, but significant fluid retention led to it discontinuation. A year-and-a- half ago, basal insulin was added to her lifestyle and metformin management. She now administers 52 units (0.62 units/kg) once daily at bedtime. Since starting basal insulin, she has experienced 3 episodes of mild hypoglycemia. Since her diagnosis, Mary’s HbA1c has never been <7.0%; her current HbA1c is 7.9%. Over the past month, her fasting plasma glucose (FPG) has ranged from 103 mg/dL to 136 mg/dL and her postprandial glucose (PPG) from 164 mg/dL to 213 mg/dL. She has gained 2.6 kg since starting basal insulin and her body mass index is now 31 kg/m2. Her blood pressure is 134/82 mmHg. She experiences occasional tingling in her feet. Eye examination reveals grade 1 retinopathy. Current medications are: metformin 1000mg twice daily, basal insulin 52 units once daily at bedtime, and hydrochlorothiazide 25 mg once daily. Her family physician notes that Mary’s FPG is reasonably well-controlled, yet her HbA1c and PPG remain elevated. He is also concerned about her episodes of hypoglycemia and weight gain and the evidence indicating microvascular damage. -
Performance of the Insulin-Only Ilet Bionic Pancreas and The
e118 Diabetes Care Volume 44, June 2021 Performance of the Insulin-Only Luz E. Castellanos,1 Courtney A. Balliro,1 Jordan S. Sherwood,1 Rabab Jafri,1 iLet Bionic Pancreas and the Mallory A. Hillard,1 Evelyn Greaux,1 Rajendranath Selagamsetty,2 Hui Zheng,3 Bihormonal iLet Using Firas H. El-Khatib,2 Edward R. Damiano,2,4 and Dasiglucagon in Adults With Type Steven J. Russell1 1 Diabetes in a Home-Use Setting Diabetes Care 2021;44:e118–e120 | https://doi.org/10.2337/dc20-1086 Reductions in blood glucose levels in with insulin lispro (Eli Lilly) or aspart (Table 1). The mean CGM glucose and people with diabetes are often achieved (Novo Nordisk), the bihormonal iLet for time in range (70–180 mg/dL) were 149 at the expense of increased hypoglyce- 7dayswithdasiglucagon(4mg/mL) ±13mg/dLand72±8%,respectively,in mia. A novel approach is to automati- and insulin lispro or aspart, or both, us- the insulin-only period, and 139 ± 11 cally deliver microdose glucagon when ing the same glucose target (110 mg/ mg/dL and 79 ± 9%, respectively, in the automation of insulin delivery alone is dL), in random order. There were no re- bihormonal period. The mean daily car- not sufficient to prevent hypoglycemia. strictions on diet or exercise. The prima- bohydrates consumed to prevent or The approach requires a bihormonal de- ry outcomes were prespecified iLet treat hypoglycemia were 16 ± 13 g and vice and a stable form of glucagon or operational thresholds. The key second- 18 ± 21 g in the insulin-only and bihor- glucagon analog. -
A 26-Week Randomized Controlled Trial of Semaglutide Once Daily Versus Liraglutide and Placebo in Patients with Type 2 Diabetes
1926 Diabetes Care Volume 41, September 2018 Ildiko Lingvay,1 Cyrus V. Desouza,2 A 26-Week Randomized Katarina S. Lalic,3 Ludger Rose,4 Thomas Hansen,5 Jeppe Zacho,5 and Controlled Trial of Semaglutide Thomas R. Pieber6 EMERGING THERAPIES: DRUGS AND REGIMENS Once Daily Versus Liraglutide and Placebo in Patients With Type 2 Diabetes Suboptimally Controlled on Diet and Exercise With or Without Metformin Diabetes Care 2018;41:1926–1937 | https://doi.org/10.2337/dc17-2381 OBJECTIVE To investigate the efficacy and safety of once-daily semaglutide in comparison with once-daily liraglutide and placebo in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS This 26-week, multicenter, double-blind trial involved patients diagnosed with 1University of Texas Southwestern Medical Cen- type 2 diabetes with HbA1c 7.0–10.0% (53–86 mmol/mol) and treated with diet ter at Dallas, Dallas, TX and exercise with or without metformin. Patients were randomized 2:2:1 to once- 2University of Nebraska Medical Center, Omaha, daily semaglutide, liraglutide, or placebo in one of four volume-matched doses NE 3Faculty of Medicine, University of Belgrade, and (semaglutide 0.05, 0.1, 0.2, or 0.3 mg and liraglutide 0.3, 0.6, 1.2, or 1.8 mg, with Clinic for Endocrinology, Diabetes and Metabolic both compared within each volume-matched dose group). Primary end point was Diseases, Clinical Center of Serbia, Belgrade, Serbia change in HbA1c from baseline to week 26. 4Institute for Diabetes Research in Munster,¨ RESULTS Munster,¨ Germany 5Novo Nordisk A/S, Søborg, Denmark In total, 705 randomized patients were exposed to trial products. -
A Network Meta-Analysis Comparing Exenatide Once Weekly with Other GLP-1 Receptor Agonists for the Treatment of Type 2 Diabetes Mellitus
Diabetes Ther DOI 10.1007/s13300-016-0155-1 REVIEW A Network Meta-analysis Comparing Exenatide Once Weekly with Other GLP-1 Receptor Agonists for the Treatment of Type 2 Diabetes Mellitus Sheena Kayaniyil . Greta Lozano-Ortega . Heather A. Bennett . Kristina Johnsson . Alka Shaunik . Susan Grandy . Bernt Kartman To view enhanced content go to www.diabetestherapy-open.com Received: December 17, 2015 Ó The Author(s) 2016. This article is published with open access at Springerlink.com ABSTRACT treatment of adults with T2DM inadequately controlled on metformin monotherapy. Introduction: Exenatide is a glucagon-like Methods: A systematic literature review was peptide-1 receptor agonist (GLP-1 RA), conducted to identify randomized controlled approved for treatment of type 2 diabetes trials (RCTs) that investigated GLP-1 RAs mellitus (T2DM). There is limited direct (albiglutide, dulaglutide, exenatide, liraglutide, evidence comparing the efficacy and and lixisenatide) at approved doses in the tolerability of exenatide 2 mg once weekly United States/Europe, added on to metformin (QW) to other GLP-1 RAs. A network only and of 24 ± 6 weeks treatment duration. meta-analysis (NMA) was conducted to A Bayesian NMA was conducted. estimate the relative efficacy and tolerability of Results: Fourteen RCTs were included in the exenatide QW versus other GLP-1 RAs for the NMA. Exenatide QW obtained a statistically significant reduction in glycated hemoglobin (HbA1c) relative to lixisenatide 20 lg once daily. No other comparisons of exenatide QW Electronic supplementary material The online version of this article (doi:10.1007/s13300-016-0155-1) to other GLP-1 RAs were statistically significant contains supplementary material, which is available to for change in HbA1c. -
Subcutaneous Semaglutide, Dulaglutide and Liraglutide 1.2Mg for the Treatment of Type
North Central London Joint Formulary Committee Factsheet Subcutaneous SEMAGLUTIDE▼ (Ozempic®), DULAGLUTIDE▼ (Trulicity®) and LIRAGLUTIDE 1.2mg (Victoza®) Treatment of Type 2 Diabetes Mellitus Start date: December 2019 Review date: August 2022 Document Control Date Version Action July 2016 1.0 New guideline August 2019 1.1 Subcutaneous semaglutide added as the preferred GLP-1 receptor agonist November 2019 1.2 Supply quantities added Agreed by NCL Shared Care Group: December 2019 FACTSHEET TO FACILITATE PRESCRIBING PLEASE NOTE THIS IS NOT A SHARED CARE GUIDELINE, NOR IS IT A FULL SUMMARY OF DRUG INFORMATION. ALWAYS REFER TO THE MOST RECENT BNF AND/OR SUMMARY OF PRODUCT CHARACTERISTICS. Disclaimer This Fact Sheet is registered at North Central London (NCL) Joint Formulary Committee (JFC) and is intended solely for use by healthcare professionals to aid the treatment of patients within NCL. However, this fact sheet is for guidance only, its interpretation and application remains the responsibility of the individual clinician. If in doubt, contact a senior colleague or expert. Clinicians are advised to refer to the manufacturer’s current prescribing information before treating individual patients. The authors and NCL JFC accept no liability for use of this information from this beyond its intended use. While we have tried to compile accurate information in this document, and to keep it updated in a timely manner, we cannot guarantee that it is fully complete and correct at all times. If you identify information within this document that is inaccurate, please report this to the [email protected]. If a patient is harmed as a consequence of following this document, please complete a local incident report and inform [email protected]. -
Victoza® (Liraglutide) Injection LEADER: Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results
Novo Nordisk Victoza® (liraglutide) NDA 22341 S-027 Endocrinologic and Metabolic Drug Advisory Committee, June 20, 2017 Victoza® (liraglutide) injection LEADER: Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results NDA 22341 S-027 Briefing Document Endocrinologic and Metabolic Drug Advisory Committee June 20, 2017 Advisory Committee Briefing Materials: Available for Public Release Novo Nordisk Victoza® (liraglutide) NDA 22341 S-027 Endocrinologic and Metabolic Drug Advisory Committee, June 20, 2017 2 of 95 1 Executive summary Introduction Liraglutide is an analog with 97% homology to human glucagon-like peptide-1 (GLP-1) and acts as a GLP-1 receptor agonist (GLP-1 RA). Liraglutide (Victoza®) obtained marketing authorization in the United States (US) in 2010 and is currently approved in over 100 countries worldwide. In the US, Victoza® (for subcutaneous injection 1.2 mg and 1.8 mg once-daily) is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (T2DM) as mono- or combination therapy.1 The exposure to Victoza® in the post-marketing setting is extensive; as of 30 June 2016, the cumulative exposure was estimated to be greater than 6 million patient-years of exposure to Victoza®. The LEADER trial (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results) was a cardiovascular outcomes trial designed and conducted to determine the effect and long-term safety of liraglutide versus placebo on cardiovascular outcomes as -
GLP-1 Receptor Agonists Reference Number: CP.HNMC.16 Effective Date: 11.16.16 Last Review Date: 11.17 Revision Log Line of Business: Medicaid – Medi-Cal
Clinical Policy: GLP-1 Receptor Agonists Reference Number: CP.HNMC.16 Effective Date: 11.16.16 Last Review Date: 11.17 Revision Log Line of Business: Medicaid – Medi-Cal See Important Reminder at the end of this policy for important regulatory and legal information. Description The following are GLP-1 Receptor Agonists requiring prior authorization: lixisenatide (Adlyxin™), Exenatide Extended-Release (Bydureon®), Exenatide (Byetta®), Pramlintide Acetate (Symlin®), Albiglutide (Tanzeum®), Dulaglutide (Trulicity®), Liraglutide (Victoza®), Liraglutide and insulin degludec (Xultophy®),Insulin glargine and lixisenatide (Soliqua®). FDA approved indication Adlyxin, Bydureon, Byetta, Tanzeum, Trulicity, Victoza are indicated: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Adlyxin limitation of use: Has not been studied in patients with chronic pancreatitis or a history of unexplained pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis. Not for treatment of type 1 diabetes or diabetic ketoacidosis. Has not been studied in combination with short acting insulin. Has not been studied in patients with gastroparesis and is not recommended in patients with gastroparesis. Bydureon limitation of use: Not recommended as first-line therapy for patients inadequately controlled on diet and exercise. Should not be used to treat type 1 diabetes or diabetic ketoacidosis. Use with insulin has not been studied and is not recommended. Has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis. Byetta limitation of use: Not a substitute for insulin. Byetta should not be used for the treatment of type 1 diabetes or diabetic ketoacidosis. -
Efficacy and Safety of Taspoglutide Versus Sitagliptin
Diabetes Ther (2012) 3:13 DOI 10.1007/s13300-012-0013-8 ORIGINAL RESEARCH Efficacy and Safety of Taspoglutide Versus Sitagliptin for Type 2 Diabetes Mellitus (T-Emerge 4 Trial) Richard M. Bergenstal • Adriana Forti • Jean-Louis Chiasson • Michael Woloschak • Mark Boldrin • Raffaella Balena To view enhanced content go to www.diabetestherapy-open.com Received: August 9, 2012 / Published online: November 9, 2012 Ó The Author(s) 2012. This article is published with open access at Springerlink.com ABSTRACT sitagliptin or placebo, as adjunct to metformin, in patients with inadequately Introduction: The efficacy and safety of controlled type 2 diabetes. taspoglutide, a long-acting human glucagon- Methods: In this randomized, double-blind, like peptide-1 analog, were compared with double-dummy, parallel-group trial, patients were randomized to taspoglutide 10 mg once For the T-emerge 4 Study Group. weekly (QW), 20 mg QW, 100 mg sitagliptin Study investigators listed in the Appendix. once daily (QD), or placebo for 24 weeks, ClinicalTrials.gov identifier: NCT00754988. followed by 28-week short-term and 104-week long-term extension periods. The primary R. M. Bergenstal (&) endpoint was change in glycosylated Park Nicollet International Diabetes Center, hemoglobin (HbA ) after 24 weeks. Minneapolis, MN 55416, USA 1c e-mail: [email protected] Results: In this study, 666 patients (baseline HbA , 7.96% [SD, 0.87]; fasting plasma glucose, A. Forti 1c Universidade Federal do Ceara´, Fortaleza, Brazil 9.61 mmol/L [2.56]; body weight, 92.4 kg [19.3]) were randomized to taspoglutide 10 mg J.-L. Chiasson Centre de Recherche, Centre Hospitalier de QW (n = 190), 20 mg QW (n = 198), l’Universite´ de Montre´al, Universite´ de Montre´al, 100 mg sitagliptin QD (n = 185), or placebo Montreal, QC H2Q 1T8, Canada (n = 93) for 24 weeks. -
Study Protocol
CLINICAL TRIAL REPORT ZP4207-17086 (ZEA-DNK-02170) 16.1 TRIAL INFORMATION 16.1.1 PROTOCOL AND PROTOCOL AMENDMENTS This appendix includes Document Date, Version Clinical trial protocol Version 1.0, 08 June 2018 (valid in Slovenia and the USA) Version 3.0, 08 January 2019 (valid in Germany) Section 16.1.1: Protocol and Protocol Amendments Clinical Trial Protocol, final version 1.0 ZP4207-17086 (ZEA-DNK-02170) Clinical Trial Protocol A phase 3, randomized, double-blind, placebo- and active-controlled, parallel-arm trial to assess the efficacy, safety, and pharmacokinetics of dasiglucagon relative to placebo and GlucaGen® when administered as a rescue therapy for severe hypoglycemia in children with T1DM treated with insulin Sponsor code: ZP4207-17086 Synteract: ZEA-DNK-02170 EudraCT number: 2018-000892-33 Coordinating investigator: Prof. Dr. med. Thomas Danne Allgemeine Kinderheilkunde Diabetologie, Endokrinologie, Klinische Forschung Diabeteszentrum für Kinder und Jugendliche AUF DER BULT Kinder- und Jugendkrankenhaus Janusz-Korczak-Allee 12 30173 Hannover Germany Sponsor: Zealand Pharma A/S Smedeland 36 2600 Glostrup, Copenhagen Denmark Version: final version 1.0 Date: 08 June 2018 GCP statement This trial will be performed in compliance with Good Clinical Practice, the Declaration of Helsinki (with amendments) and local legal and regulatory requirements. 08 June 2018 CONFIDENTIAL Page 1/55 Zealand Pharma A/S ClinicalTrial Prolocol, final ve¡sion 1.0 zP 42A7 -1 7 A 86 (ZEA-DN K-02 1 L Slgnature¡ and agreoment wlth protocot Tltle: phase A 3, ¡andomized, double-blind, placebo- and aclivg-controlled, parallel-arm trial to assess the efficac¡ safety, and pharmacoítinetics of dasiglucagon rela¡ve to placebo and GlucaGeno when edministered as a rescue thêrapy for sevãre triposivcemia ¡n children w¡th TlDM treated with insulin we, the undersigned, agroe to conduct lhls trlal according to lhe Trlal protocol. -
Weekly Semaglutide Vs. Liraglutide Efficacy Profile: a Network Meta
healthcare Systematic Review Weekly Semaglutide vs. Liraglutide Efficacy Profile: A Network Meta-Analysis Hassan A. Alsugair 1,* , Ibrahim F. Alshugair 2 , Turki J. Alharbi 1,*, Abdulaziz M. Bin Rsheed 1 , Ayla M. Tourkmani 1 and Wedad Al-Madani 3 1 Family Medicine Department, Prince Sultan Military Medical City, Riyadh 12624, Saudi Arabia; [email protected] (A.M.B.R.); [email protected] (A.M.T.) 2 Orthopedic Surgery Department, King Saud Medical City, Riyadh 12746, Saudi Arabia; [email protected] 3 General Authority of Statistics, Riyadh 11481, Saudi Arabia; [email protected] * Correspondence: [email protected] or [email protected] (H.A.A.); [email protected] or [email protected] (T.J.A.); Tel.: +966-114777714-40438 (T.J.A.) Abstract: Introduction: Glucagon-like peptide 1 receptor agonist (GLP-1 RA) is a class of hypo- glycemic medications. Semaglutide once-weekly (QW) and liraglutide once-daily (OD) significantly improved glycemic control compared to placebo. To date, no long-term phase III trials directly comparing semaglutide and liraglutide are available. This network meta-analysis (NMA) aims to compare the long-term efficacy of semaglutide and liraglutide. Methods: PubMed, Embase, and Cochrane Library were searched from inception until June 2019 to identify relevant articles. Nine long-term randomized controlled trials comparing once-weekly semaglutide or liraglutide with placebo or other active comparisons were identified. The outcomes of interest were changes in HbA1c and weight after 52 weeks. A Bayesian framework and NMA were used for data synthesis. Citation: Alsugair, H.A.; This is a sub-study of the protocol registered in PROSPERO (number CRD42018091598).