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Rivista sulle Malattie del Sistema Endocrino
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Endocrinologica 2014 December;39(4):289-97
Multiple drug combination of anti-diabetic agents as a predictor for poor clinical response to liraglutide
Haraguchi A. 1, Fujishima K. 2, Ando T. 1, Mori F. 1, Imaizumi M. 1, Abiru N. 1, Yamasaki H. 2, Matsumoto K. 3, Takamura N. 4, Kawakami A. 1 ✉
1 Division of Endocrinology and Metabolism, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan;
2 Center for Health and Community Medicine, Nagasaki University, Nagasaki, Japan;
3 Diabetes Center, Sasebo Chuo Hospital, Sasebo, Japan;
4 Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
AIM: Aim of the study was to retrospectively analyze the clinical parameters that contribute to the therapeutic outcome of GLP-1 analogues.
METHODS: We enrolled 106 patients with type 2 diabetes mellitus (T2DM), treated with liraglutide (N.=69) or exenatide (N.=37) for longer than three months. The patients were divided into two groups: good responders and poor responders to GLP-1 analogues, based on pretreatment and post-treatment HbA1c levels. Good responders were those whose HbA1c level had decreased by 1% or more, or maintained at less than 7%. All other patients were categorized as poor responders. We used univariate and multivariate analyses to assess pretreatment parameters between the two groups.
RESULTS: Approximately 35% of the patients were poor responders. Our analysis of the pretreatment clinical parameters revealed that number of anti-diabetic agents and use of sulfonylurea were significantly associated with poor response to liraglutide (P=0.02 and P=0.03, respectively) in a multivariate analysis. We were not able to find any candidate related to clinical response to exenatide.
CONCLUSION: Our study showed that the therapeutic effects of GLP-1 analogues on T2DM patients were heterogeneous. T2DM patients who require multiple anti-diabetic agents, especially sulfonylurea, do not benefit from liraglutide treatment.