June 09, 2012
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Exenatide bested insulin, pioglitazone for HbA1c, weight reduction in type 2 diabetes

PHILADELPHIA — Compared with insulin and pioglitazone, exenatide was associated with reduced HbA1c and greater weight loss among newly diagnosed and drug-naïve patients with type 2 diabetes, according to data from the CONFIDENCE trial.

The trial compared the efficacy of exenatide (Byetta, Bydureon; Amylin) with insulin and pioglitazone (Actos, Takeda Pharmaceuticals) among 416 newly diagnosed or treatment-naïve patients with HbA1c between 7% and 10%. Patients were enrolled from 25 centers in China and had similar baseline characteristics.

More than 100 patients completed 24 weeks of treatment (n=127), at which time HbA1c, fasting plasma glucose and 2-hour plasma glucose after a fixed breakfast had decreased across all three groups. Patients in the exenatide and insulin groups, however, experienced significant reductions in HbA1c compared with the pioglitazone group (–1.8% and –1.8% vs. –1.3%; P=.036).

Additionally, exenatide was associated with increased weight reduction compared with both groups (–5 kg vs. –0.7 kg for insulin and –2.6 kg for pioglitazone; P<.01).

“Compared with insulin and pioglitazone, 24-week exenatide treatment is more effective on glycemic control, accompanied with more distinct weight reduction in newly diagnosed and drug-naïve type 2 diabetes,” Wen Xu, MD, from the Third Affiliated Hospital of Sun Yat-sen University, said during her presentation.

There were no severe hypoglycemic events in any patients, and the most common adverse event in the exenatide group was gastrointestinal reactions, occurring among 60% of patients. Acute pancreatitis occurred in one patient in the exenatide group.

Compared with insulin and pioglitazone, 24-week exenatide treatment is more effective for glycemic control, accompanied by more distinct weight reduction in newly diagnosed and drug-naïve type 2 diabetes.

“This is just the preliminary data from our CONFIDENCE trial, and it will be finished this year; I’m looking forward to presenting the results at that time.” – by Stacey L. Fisher

For more information:

Xu W. Abstract #12-OR. Presented at: American Diabetes Association 72nd Scientific Sessions; June 8-12, 2012; Philadelphia.

Disclosure: Dr. Xu reports no relevant financial disclosures.