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Efficacy and safety of switching from sitagliptin to liraglutide in subjects with type 2 diabetes ( LIRA‐SWITCH ): a randomized, double‐blind, double‐dummy, active‐controlled 26‐week trial
Author(s) -
Bailey T. S.,
Takács R.,
Tinahones F. J.,
Rao P. V.,
Tsoukas G. M.,
Thomsen A. B.,
Kaltoft M. S.,
Maislos M.
Publication year - 2016
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12736
Subject(s) - liraglutide , sitagliptin , medicine , clinical endpoint , type 2 diabetes , metformin , sitagliptin phosphate , weight loss , randomized controlled trial , urology , endocrinology , gastroenterology , diabetes mellitus , obesity
Aims To confirm superiority on glycaemic control by switching from sitagliptin to liraglutide 1.8 mg/d versus continued sitagliptin. Materials and methods A randomized, multicentre, double‐blind, double‐dummy, active‐controlled trial across 86 office‐ or hospital‐based sites in N orth A merica, E urope and A sia. Subjects with type 2 diabetes who had inadequate glycaemic control (glycated haemoglobin [ HbA1c ] 7.5−9.5% on sitagliptin (100 mg/d) and metformin (≥1500 mg daily) for ≥90 days were randomized to either switch to liraglutide (n = 203) or continue sitagliptin (n = 204), both with metformin. The primary endpoint was change in HbA1c from baseline to week 26. Change in body weight was a confirmatory secondary endpoint. Results Greater reduction in mean HbA1c was achieved with liraglutide than with continued sitagliptin [−1.14% vs. −0.54%; estimated mean treatment difference ( ETD ): −0.61% (95% CI −0.82 to −0.40; p < 0.0001)], confirming superiority of switching to liraglutide. Body weight was reduced more with liraglutide [−3.31 kg vs. −1.64 kg; ETD : −1.67 kg (95% CI −2.34 to −0.99; p < 0.0001)]. Nausea was more common with liraglutide [44 subjects (21.8%)] than with continued sitagliptin [16 (7.8%)]. Three subjects (1.5%) taking sitagliptin reported a confirmed hypoglycaemic episode. Conclusions Subjects insufficiently controlled with sitagliptin who switch to liraglutide can obtain clinically relevant reductions in glycaemia and body weight, without compromising safety. A switch from sitagliptin to liraglutide provides an option for improved management of type 2 diabetes while still allowing patients to remain on dual therapy.