Achieving the composite endpoint of glycated haemoglobin <7.0%, no weight gain and no hypoglycaemia in the once-weekly dulaglutide AWARD programme

Diabetes Obes Metab. 2016 Jan;18(1):49-55. doi: 10.1111/dom.12575. Epub 2015 Nov 3.

Abstract

Aim: To compare the effectiveness of dulaglutide 1.5 and 0.75 mg with active comparators and placebo with regard to a composite endpoint of glycated haemoglobin (HbA1c), weight and hypoglycaemia, using post hoc analyses.

Methods: A logistic regression analysis was performed on the intention-to-treat population, using data from the last observation carried forward, and the composite endpoint of HbA1c <7.0% (53 mmol/mol), no weight gain (≤0 kg) and no hypoglycaemia (glucose <3.0 mmol/l or severe hypoglycaemia) after 26 weeks for each trial in the AWARD programme separately.

Results: At 26 weeks, within each study, 37-58% of patients on dulaglutide 1.5 mg, 27-49% of patients on dulaglutide 0.75 mg, and 9-61% of patients on active comparators achieved the composite endpoint. Significantly more patients reached the composite endpoint with dulaglutide 1.5 mg than with metformin, sitagliptin, exenatide twice daily or insulin glargine: odds ratio (OR) 1.5 [95% confidence interval (CI) 1.0, 2.2; p < 0.05], OR 4.5 (95% CI 3.0, 6.6; p < 0.001), OR 2.6 (95% CI 1.8, 3.7; p < 0.001) and OR 7.4 (95% CI 4.4, 12.6; p < 0.001), respectively, with no difference between dulaglutide 1.5 mg and liraglutide 1.8 mg. In addition, significantly more patients reached the composite endpoint with dulaglutide 0.75 mg than with sitagliptin or insulin glargine: OR 3.3 (95% CI 2.2, 4.8; p < 0.001) and OR 4.5 (95% CI 2.7, 7.8; p < 0.001), respectively.

Conclusions: Dulaglutide is an effective treatment option, resulting in a similar or greater proportion of patients reaching the HbA1c target of <7.0% (53 mmol/mol), without weight gain or hypoglycaemia compared with active comparators.

Keywords: GLP-1 analogue; composite endpoint; dulaglutide.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Drug Administration Schedule
  • Exenatide
  • Female
  • Glucagon-Like Peptides / administration & dosage
  • Glucagon-Like Peptides / analogs & derivatives*
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / drug effects*
  • Humans
  • Hypoglycemia / chemically induced
  • Hypoglycemic Agents / administration & dosage*
  • Immunoglobulin Fc Fragments / administration & dosage*
  • Liraglutide / administration & dosage
  • Male
  • Metformin / administration & dosage
  • Middle Aged
  • Peptides / administration & dosage
  • Randomized Controlled Trials as Topic
  • Recombinant Fusion Proteins / administration & dosage*
  • Sitagliptin Phosphate / administration & dosage
  • Treatment Outcome
  • Venoms / administration & dosage
  • Weight Gain / drug effects*

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Immunoglobulin Fc Fragments
  • Peptides
  • Recombinant Fusion Proteins
  • Venoms
  • hemoglobin A1c protein, human
  • Glucagon-Like Peptides
  • Liraglutide
  • Metformin
  • Exenatide
  • Sitagliptin Phosphate
  • dulaglutide