Thefateof taspoglutide,aweeklyglp-1 receptor agonist, versus twice-daily exenatide for type 2 diabetes

Abstract

OBJECTIVEdTaspoglutide is a long-acting glucagon-like peptide 1 receptor agonist developed for treatment of type 2 diabetes. The efficacy and safety of once-weekly taspoglutide was compared with twice-daily exenatide. RESEARCH DESIGN AND METHODSdOverweight adults with inadequately controlled type 2 diabetes on metformin 6 a thiazolidinedione were randomized to subcutaneous taspoglutide 10 mg weekly (n = 399), taspoglutide 20 mg weekly (n = 398), or exenatide 10 mg twice daily (n = 392) in an open-label, multicenter trial. The primary end point was change in HbA1c after 24 weeks. RESULTSdMean baseline HbA1c was 8.1%. Both doses of taspoglutide reduced HbA1c significantly more than exenatide (taspoglutide 10 mg:-1.24%[SE 0.09], difference-0.26, 95%CI-0.37 to-0.15, P < 0.0001; taspoglutide 20 mg:-1.31% [0.08], difference-0.33,-0.44 to-0.22, P < 0.0001; exenatide:-0.98% [0.08]). Both taspoglutide doses reduced fasting plasma glucose significantly more than exenatide. Taspoglutide reduced body weight (taspoglutide 10 mg,-1.6 kg; taspoglutide 20 mg,-2.3 kg) as did exenatide (-2.3 kg), which was greater than with taspoglutide 10 mg (P < 0.05). HbA1c and weight effects were maintained after 52 weeks. More adverse eventswith taspoglutide 10 and 20mgthan exenatide developed over time (nausea in 53, 59, and 35% and vomiting in 33, 37, and 16%, respectively). Allergic and injection-site reactions were more common with taspoglutide. Discontinuations were greater with taspoglutide. Antitaspoglutide antibodies were detected in 49% of patients. CONCLUSIONSdOnce-weekly taspoglutide demonstrated greater glycemic control than twice-daily exenatide with comparable weight loss, but with unacceptable levels of nausea/vomiting, injection-site reactions, and systemic allergic reactions. Copyright © 2013 by the American Diabetes Association.