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Sitagliptin and exenatide backed as diabetes drug options

By Lilian Anekwe

New data has confirmed the efficacy of two anti-diabetes drugs newly recommended by NICE.

Studies published at the American Diabetes Association conference in New Orleans found sitagliptin and exenatide are both viable treatment options.

A two-year analysis of the efficiacy of sitagliptin as an add-on therapy to metformin in 852 patients found addition of sitagliptin to metformin decreased the mean HbA1c from a baseline of 8.0% to 6.9% after two years.

Sitagliptin was approved by NICE last month as a second-line option for patients with type 2 diabetes who are at significant risk of hypoglycaemia or intolerant of or contraindicated for sulfonylureas or glitazones.

NICE also approved use of exenatide as a third-line option in patients with a BMI of more than 35 kg/m2 and a second analysis of more than 44,000 patients found body weight decreased by 3kg in patients on exenatide and 1.1kg in patients on sitagliptin, compared with a 0.6kg weight gain seen in patients on insulin.

Patients who lost weight after treatment with exenatide showed a decrease in HbA1c of 0.55%, while the reduction in the sitagliptin group was 0.51%.

Study leader Dr Julio Rosenstock, clinical professor of medicine at the University of Texas Southwestern Medical School in Dallas, concluded: ‘In a real-world setting, weight loss is associated with a significant incremental benefit in glycaemic control in patients receiving a GLP-1 angonist'

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