title: Comparative Assessment of Lixisenatide, Exenatide, and Liraglutide Pen Devices: A Pilot User-Based Study.
abstract: BACKGROUND
  Glucagon-like peptide-1 (GLP-1) receptor agonists are a relatively recent addition to the treatment options for type 2 diabetes mellitus (T2DM) and are administered using prefilled pen devices.
  
  
  METHODS
  In this open-label task and interview-based pilot study, 3 GLP-1 receptor agonist pen devices-exenatide (Byetta®, Bristol-Myers Squibb/AstraZeneca), liraglutide (Victoza®, Novo Nordisk), and lixisenatide (Lyxumia®, Sanofi-Aventis)-were comparatively assessed in a randomized order in 30 participants with T2DM for ease of use, using a series of key performance measures (time taken to complete a series of tasks, number of user errors [successful performance], and user satisfaction rating). Linear and logistic regression analysis was conducted for the lixisenatide and liraglutide pens versus the exenatide pen. Participants' mean age was 60 years; 27% and 20% of the participants had visual impairments and reduced manual dexterity, respectively.
  
  
  RESULTS
  Tasks were completed faster (P < .001) and with higher successful performance (P = .001) with the lixisenatide pen than with the exenatide pen, whereas the liraglutide pen was not statistically significant versus the exenatide pen on these parameters. Overall, user satisfaction was statistically higher for the lixisenatide and liraglutide pens versus the exenatide pen (P < .001 for both).
  
  
  CONCLUSIONS
  Lixisenatide and liraglutide pens are associated with higher user satisfaction compared with the exenatide pen. In addition, the lixisenatide pen is faster and results in fewer errors than its comparator (exenatide). The lixisenatide pen may therefore be a suitable choice for patients with T2DM, including older and pen device-naïve patients, and those with visual impairments and reduced manual dexterity.
authors.affiliation: Sanofi-Aventis, Frankfurt, Germany DCA Design International, Warwick, UK Jean Minjoz Hospital, Besançon, France University of California, San Diego, San Diego, CA, USA Udo.Stauder@sanofi.com.
authors.forename: Udo
authors.initials: U
authors.lastname: Stauder
authors.affiliation: Sanofi-Aventis, Frankfurt, Germany.
authors.forename: Diplom
authors.initials: D
authors.lastname: Enginee
authors.affiliation: DCA Design International, Warwick, UK.
authors.forename: Hina
authors.initials: H
authors.lastname: Elton
authors.affiliation: Jean Minjoz Hospital, Besançon, France.
authors.forename: Alfred
authors.initials: A
authors.lastname: Penfornis
authors.affiliation: University of California, San Diego, San Diego, CA, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Edelman
keywords: ease of use; glucagon-like peptide-1 receptor agonists; lixisenatide; prefilled pen devices; type 2 diabetes mellitus