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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.

diabetes, obesity and metabolism

Achieving the composite endpoint of glycated haemoglobin &lt;7.0%, no weight gain and no hypoglycaemia in the once‐weekly dulaglutide  AWARD  programme