Weekly exenatide for type 2 diabetes delivers in real world

Exenatide once weekly (EOW) provides effective glucose control and weight loss in patients with type 2 diabetes mellitus (T2DM), and these benefits are sustained through 18 months of treatment, according to real-world data.

The analysis included 186 patients (mean age, 63.2 years; 46.2 percent male; diabetes duration, 10.7 years) treated with EOW 2 mg in a real-world setting. These patients attended follow-up visits at 6, 12, and 18 months after treatment initiation.

After 6 months of treatment, HbA_1c values dropped significantly (−0.9 percent, 95 percent confidence interval [CI], −1.1 to −0.8), as well as body weight (−2.8 kg, 95 percent CI, −3.4 to −2.2). More than half of the population (61 percent) achieved target HbA_1c values of ≤7 percent, while 34 percent shed at least 5 percent of their baseline body weight at the 12-month follow up.

The reductions in blood sugar and weight were maintained at 18 months.

Shorter diabetes duration and nonuse of a different glucagon-like peptide-1 receptor agonist (GLP-1RA) predicted adequate glycaemic and weight response, respectively. Of note, patients on sulfonylureas failed to reach metabolic and body weight targets.

Gastrointestinal side effects (7.5 percent) and injection site reactions (6.4 percent) were the most common adverse events. A fraction of patients developed headache (1.1 percent) and allergic reactions (1.1 percent).

Treatment was discontinued in 79 patients (43 percent) because of insufficient HbA_1c improvement and/or limited weight reduction (19.9 percent), side effects (16.1 percent), or patient decision (6.5 percent). Higher baseline HbA_1c levels and use of basal insulin therapy prior to treatment initiation predicted EOW discontinuation.

The findings suggest that early initiation of EOW could improve glycaemic control and lower the risk of treatment discontinuation.