Real‐world clinical outcomes and predictors of glycaemic and weight response to exenatide once weekly in patients with type 2 diabetes: The CIBELES project

Summary Aims To evaluate in a real‐world setting the effectiveness of exenatide once‐weekly (Ex QW ) in patients with T2D and to determine predictors of glycaemic and weight response to this drug at 6 months. Methods Observational, retrospective, multicenter study in adult patients with T2D and BMI ≥30 kg/m 2 from 4 tertiary Spanish hospitals who started Ex QW therapy at least 6 months before the inclusion and had not achieved adequate glycaemic control on oral therapies or other GLP ‐1 receptor agonists. Glycaemic response was defined as an A1C reduction ≥1.0% and weight response as a weight loss ≥3% 6 months after Ex QW . The best predictive models of glycaemic and weight response were estimated by binary logistic regression. Results One hundred and forty eight patients were included, mean age 58.0 years, A1C 7.7%, weight 105.9 kg and BMI 38.4 kg/m 2 . A1C (−1.1%), weight (−3.9 kg), systolic blood pressure (−4.0 mm Hg), diastolic blood pressure (−2.9 mm Hg), LDL ‐cholesterol (−14.2 mg/dL) and triglycerides (−31.0 mg/dL) significantly decreased 6 months after Ex QW . 41.5% of patients had an A1C reduction ≥1.0% and 53.1% lost ≥3% of baseline weight. Glycaemic and weight reductions were sustained in patients completing 1 and 2 years of follow‐up. The best predictive model of glycaemic response only included higher A1C levels ( OR 3.9), whereas higher BMI ( OR 1.1) and prior DPP ‐4i therapy ( OR 3.1) were associated to weight response in the multivariate analysis. Conclusions In a real‐world setting, Ex QW significantly decreased A1C, weight, blood pressure and lipids at 6 months. Our study identified higher baseline A1C as the sole independent predictor of glycaemic response to Ex QW and higher BMI and previous DDP 4i treatment as predictive factors of meaningful weight response.