New Diabetes Drugs Have Different Advantages, Study Says

One is injected daily, the other weekly and both have side effects

Wednesday, November 7, 2012

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WEDNESDAY, Nov. 7 (HealthDay News) -- A head-to-head comparison of two new type 2 diabetes drugs produced mixed results.
In the study, liraglutide (Victoza) was somewhat better than the other drug, exenatide (Bydureon), in lowering blood sugar and weight, but Bydureon was associated with fewer side effects, researchers said.
Victoza is injected daily by patients and Bydureon is injected weekly. Both drugs are classified as "glucagon-like peptide-1 receptor agonists."
"These treatments are very powerful blood sugar-lowering agents that don't cause [too-low] blood sugar and are associated with weight loss," said lead researcher Dr. John Buse, a professor of medicine at the University of North Carolina at Chapel Hill. "That's a unique profile for a diabetes drug."
Patients can choose between them, Buse said. A lot depends on what the person is comfortable with. "You lay this all out for patients and help them decide," he said.
"The big frontier for patients with a chronic disease like diabetes is adherence to treatment: Patients developing a plan and sticking with a plan in managing their disease," Buse explained.
This study provides information for patients and doctors to use in coming up with a plan based on the effectiveness of the drugs, their side effects and how often they are injected, Buse noted.
The study, published online Nov. 7 in The Lancet, was funded by Eli Lilly and Amylin Pharmaceuticals, the makers of Bydureon.
For the study, researchers randomly assigned more than 900 patients to receive daily injections of Victoza, or weekly injections of Bydureon.
After 26 weeks, the investigators found that both drugs significantly reduced blood sugar levels. Significant drops were seen in 60 percent of the Victoza patients compared with 53 percent of those taking Bydureon.
Both drugs were associated with weight loss. Patients taking Victoza, however, lost about two pounds more than those taking Bydureon, the researchers noted.
Side effects occurred with both drugs. Nausea was the most common, reported by 21 percent of patients on Victoza compared with 9 percent among patients taking Bydureon. Diarrhea occurred in 13 percent of patients on Victoza and 6 percent of those on Bydureon, and vomiting was a problem for 11 percent of patients on Victoza compared with 4 percent on Bydureon.
Overall, 8 percent of patients dropped out of the study due to side effects, which the researchers pointed out declined for both drugs over time.
Another diabetes expert weighed in on the study medications.
"Both drugs appear to be about equivalent," said Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City.
"When these medications are used they are added to other medications that control blood sugar," he said. These include insulin and metformin, Mezitis noted.
The main difference between the drugs is daily versus weekly injections, he pointed out. "It may be easier to do it once a week, but you have to be more proficient injecting Bydureon," Mezitis said.
The mixing of the drug (Bydureon) and injecting using a larger needle may require some practice, he explained. With daily Victoza, injections are done with an smaller, thinner needle and some patients may find that better, Mezitis said.
"It depends on what the patient chooses," he said.
Mezitis noted these drugs cost anywhere from $200 to $400 a month and that many insurance companies cover them.

SOURCES: John Buse, M.D., professor of medicine, University of North Carolina, Chapel Hill; Spyros Mezitis, M.D., Ph.D., endocrinologist, Lenox Hill Hospital, New York City; Nov. 7, 2012, The Lancet, online

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