title: Multiple drug combination of anti-diabetic agents as a predictor for poor clinical response to liraglutide.
abstract: OBJECTIVE
  Aim of the study was to retrospectively analyze the clinical parameters that contribute to the therapeutic outcome of GLP-1 analogues.
  
  
  METHODS
  We enrolled 106 patients with type 2 diabetes mellitus (T2DM), treated with liraglutide (N.=69) or exenatide (N.=37) for longer than three months. The patients were divided into two groups: good responders and poor responders to GLP-1 analogues, based on pretreatment and post-treatment HbA1c levels. Good responders were those whose HbA1c level had decreased by 1% or more, or maintained at less than 7%. All other patients were categorized as poor responders. We used univariate and multivariate analyses to assess pretreatment parameters between the two groups.
  
  
  RESULTS
  Approximately 35% of the patients were poor responders. Our analysis of the pretreatment clinical parameters revealed that number of anti-diabetic agents and use of sulfonylurea were significantly associated with poor response to liraglutide (P=0.02 and P=0.03, respectively) in a multivariate analysis. We were not able to find any candidate related to clinical response to exenatide.
  
  
  CONCLUSIONS
  Our study showed that the therapeutic effects of GLP-1 analogues on T2DM patients were heterogeneous. T2DM patients who require multiple anti-diabetic agents, especially sulfonylurea, do not benefit from liraglutide treatment.
authors.affiliation: Division of Endocrinology and Metabolism Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan - takaoando@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Haraguchi
authors.forename: K
authors.initials: K
authors.lastname: Fujishima
authors.forename: T
authors.initials: T
authors.lastname: Ando
authors.forename: F
authors.initials: F
authors.lastname: Mori
authors.forename: M
authors.initials: M
authors.lastname: Imaizumi
authors.forename: N
authors.initials: N
authors.lastname: Abiru
authors.forename: H
authors.initials: H
authors.lastname: Yamasaki
authors.forename: K
authors.initials: K
authors.lastname: Matsumoto
authors.forename: N
authors.initials: N
authors.lastname: Takamura
authors.forename: A
authors.initials: A
authors.lastname: Kawakami
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000886:Anthropometry; D001645:Biguanides / Q000008:administration & dosage / Q000627:therapeutic use; D001835:Body Weight / Q000187:drug effects; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D000077270:Exenatide; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use; D000078790:Insulin Secretion; D000069450:Liraglutide; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000008:administration & dosage / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D013453:Sulfonylurea Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D053778:Thiazolidines / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D014688:Venoms / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000410:Alanine Transaminase; D001645:Biguanides; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D000069450:Liraglutide; D010455:Peptides; D013453:Sulfonylurea Compounds; D053778:Thiazolidines; D014688:Venoms