Liraglutide: effects beyond glycaemic control in diabetes treatment.
OBJECTIVE
To review the non-glycaemic effects of liraglutide, including potential improvements in body weight, systolic blood pressure (SBP) and pancreatic beta-cell function.


RESULTS
Liraglutide induced weight loss of around 2-3 kg compared with weight increases of 1-2 kg with active comparators such as insulin glargine, rosiglitazone and glimepiride. Exenatide demonstrated similar weight benefits to liraglutide, but the dipeptidyl peptidase-4 (DPP-4) inhibitors, sitagliptin, saxagliptin and vildagliptin, were weight neutral. Liraglutide was associated with decreases in SBP of 2-7 mmHg, whereas exenatide, vildagliptin and sitagliptin demonstrated SBP reductions of around 2-3 mmHg. Measures of pancreatic beta-cell function were improved with liraglutide vs. placebo, rosiglitazone and exenatide. However, DPP-4 inhibitors appear to have less effect on beta-cell function than glucagon-like peptide-1 (GLP-1) receptor agonists.


CONCLUSIONS
In addition to glycaemic control, liraglutide and the other incretin-based therapies offer additional non-glycaemic benefits to varying degrees. The ability of GLP-1 receptor agonists to provide modest, but clinically relevant improvements in body weight and SBP, and to potentially benefit beta-cell function make them an exciting therapeutic option for individuals with diabetes. In contrast, DPP-4 inhibitors are weight neutral and may have lesser benefits on beta-cell function.
McGill
J B
JB
Division of Endocrinology, Metabolism and Lipid Research, Washington University in St. Louis, St Louis, MO 63110, USA. jmcgill@dom.wustl.edu
D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000493:pharmacokinetics* / Q000627:therapeutic use; D052216:Glucagon-Like Peptide 1 / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D007328:Insulin / Q000031:analogs & derivatives; D050417:Insulin-Secreting Cells / Q000187:drug effects / Q000378:metabolism; D000069450:Liraglutide; D013810:Therapeutic Equivalency
D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D000069450:Liraglutide; D052216:Glucagon-Like Peptide 1