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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.

diabetes, obesity and metabolism

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