Busch RS, et al. - This pooled analysis is performed to analyze the treatment impacts of exenatide twice daily (BID), exenatide once weekly (QW) and insulin in patients with high baseline HbA1c (≥10.0%). The outcome of this study revealed that the treatment with exenatide or insulin both improved glycaemic control for patients with high HbA1c. Given the associated weight loss and low risk of hypoglycaemia, exenatide may be a suitable alternative to treatment with insulin in certain patients with T2D and high HbA1c.

Methods

• This post hoc examination utilized pooled data from 12 and 8 randomised controlled trials of exenatide BID and exenatide QW, respectively.
• Patients with T2D who completed not less than 6 months of treatment with exenatide BID, exenatide QW or insulin (insulin glargine, insulin detemir or insulin aspart) were categorised by baseline HbA1c.
• In this analysis they included patients with HbA1c ≥10.0%.

Results

• The current study showed both exenatide and insulin decreased HbA1c (mean ± SE reduction: -2.0% ± 0.2% [exenatide] and -2.1% ± 0.2% [insulin] in the exenatide BID studies, and -2.6% ± 0.1% [exenatide] and -2.1% ± 0.2% [insulin] in the exenatide QW studies; all P < .001).
• Body weight reduced with exenatide and increased with insulin. Systolic blood pressure reduced with exenatide QW.
• Insulin dose increased over the course of treatment.
• The most widely recognized adverse events with exenatide were gastrointestinal. Insulin was related to some hypoglycaemia risk.
• Hypoglycaemia events occurred infrequently with exenatide when given without sulphonylureas.