Juan José Gorgojo-Martínez1, Manuel Angel Gargallo-Fernández2, Miguel Brito-Sanfiel3, Arturo Lisbona-Catalán4. 1. Unit of Endocrinology and Nutrition, Hospital Universitario Fundación Alcorcón, Madrid, Spain. 2. Department of Endocrinology and Nutrition, Hospital Universitario Infanta Leonor, Madrid, Spain. 3. Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro, Madrid, Spain. 4. Department of Endocrinology and Nutrition, Hospital Universitario La Paz, Madrid, Spain.
Abstract
AIMS: To evaluate in a real-world setting the effectiveness of exenatide once-weekly (ExQW) 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/m2 from 4 tertiary Spanish hospitals who started ExQW 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 ExQW. 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/m2 . 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 ExQW. 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, ExQW 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 ExQW and higher BMI and previous DDP4i treatment as predictive factors of meaningful weight response.
AIMS: To evaluate in a real-world setting the effectiveness of exenatide once-weekly (ExQW) 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/m2 from 4 tertiary Spanish hospitals who started ExQW 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 ExQW. 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/m2 . 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 ExQW. 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, ExQW 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 ExQW and higher BMI and previous DDP4i treatment as predictive factors of meaningful weight response.
Authors: Christina M Gant; Ijmke Mensink; S Heleen Binnenmars; Job A M van der Palen; Stephan J L Bakker; Gerjan Navis; Gozewijn D Laverman Journal: PLoS One Date: 2019-06-19 Impact factor: 3.240
Authors: Eric M Bomberg; Justin R Ryder; Richard C Brundage; Robert J Straka; Claudia K Fox; Amy C Gross; Megan M Oberle; Carolyn T Bramante; Shalamar D Sibley; Aaron S Kelly Journal: Ther Adv Endocrinol Metab Date: 2019-07-27 Impact factor: 3.565
Authors: Akshay B Jain; Amar Ali; Juan J Gorgojo Martínez; Irene Hramiak; Ketan Kavia; Sten Madsbad; Louis Potier; Ben D Prohaska; Jodi L Strong; Tina Vilsbøll Journal: Int J Clin Pract Date: 2020-11-03 Impact factor: 2.503