By Lilian Anekwe
NICE has recommended liraglutide as an alternative to insulin in obese patients with uncontrolled glucose levels.
The guidance says the once-daily injection should be used as part of triple therapy for type 2 diabetes, in combination with metformin and either a sulfonylurea, or a thiazolidinedione in patients with a BMI 35kg/m2 who would benefit from weight loss.
Draft guidance published this week recommends liraglutide 1.2mg 'when control of blood glucose remains or becomes inadequate' in obese patients, who must also have 'specific psychological or medical problems associated with high body weight'.
It also approves the use of liraglutide 'where insulin therapy would have significant occupational implications, or weight loss would benefit other significant obesity-related comorbidities', and should only be continued if the patient shows an HbA1c reduction of 1% and a minimum 3% weight loss after six months.'
But NICE ruled out the use of liraglutide 1.2mg daily for dual therapy due to ‘uncertainties in the data' provided by manufacturer, Novo Nordisk, and ruled against the use of liraglutide, 1.8 mg daily.
Dr Carole Longson, health technology evaluation centre director at NICE said: ‘Liraglutide 1.2 mg daily is a clinically and cost effective treatment option as part of triple therapy regimens for some patients under restrictions.
'However we felt that there was not sufficient evidence to recommend it in dual therapy regimens for type 2 diabetes mellitus. There were disparities in the data provided by the manufacturer, particularly regarding the economic analyses of liraglutide in dual therapy regimens for this type of diabetes.'
The appraisal consultation will run until Friday 5 March.NICE draft appraisal approves liraglutide for type 2 diabetes in obese patients