Exenatide twice daily deemed efficacious across BMI ranges

(HealthDay)—For patients with type 2 diabetes, exenatide twice daily added to insulin glargine is efficacious across body mass index (BMI) ranges, according to a study published online March 29 in Diabetes, Obesity and Metabolism.

Bruce H.R. Wolffenbuttel, M.D., Ph.D., from the University of Groningen in the Netherlands, and colleagues examined the correlation between BMI ranges and treatment effects of exenatide twice daily among patients with type 2 diabetes. In two 30-week studies, patients received exenatide in addition to insulin glargine (exenatide versus insulin lispro: 627 patients; and exenatide versus placebo: 259 patients).

The researchers observed no correlation for baseline BMI with changes in efficacy parameters. Significant and similar reductions were seen in hemoglobin A1c (HbA1c; P < 0.0001) across BMI range groups in the lispro-comparator study; in the placebo-controlled study, HbA1c reductions were greater for exenatide versus placebo. Across BMI groups, significant weight loss occurred with exenatide (P < 0.0001); weight increased with both comparators. Exenatide correlated with greater achievement of HbA1c <7.0 percent without weight gain relative to comparators. Across BMI range groups, systolic blood pressure changes decreased with exenatide in the lispro-comparator study (P < 0.0001); there were no clinically meaningful changes in lipids.

"These findings suggest that BMI alone should not limit clinical decision-making or patient access to medication," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including some that supported the studies in this analysis and AstraZeneca, which manufactures exenatide and supported manuscript development and medical writing.