Victoza (liraglutide) provides significantly greater HbA1c reduction than lixisenatide in new clinical trial

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The FINANCIAL — Findings from a head-to-head trial comparing Victoza (liraglutide) and lixisenatide, both in combination with metformin, demonstrated a significantly greater reduction in HbA1c of -1.83% for liraglutide vs -1.21% for lixisenatide in adults with type 2 diabetes.Results from the LIRA-LIXI trial were announced on September 16 in an oral presentation at the 51st Annual Meeting of the European Association for the Study of Diabetes (EASD) in Stockholm, Sweden.  

The 26-week LIRA-LIXI trial compared the efficacy and safety of Victoza versus lixisenatide, both as add-on to metformin in 404 people with type 2 diabetes.1 People with type 2 diabetes treated with Victoza achieved a significantly greater reduction in HbA1c versus lixisenatide at 26 weeks, meeting the trial’s primary endpoint (-1.83% vs   -1.21%; estimated treatment difference [ETD] -0.62% [-0.80; -0.44]; P<0.0001).1 In addition, more people treated with Victoza achieved HbA1c targets of <7% (74.2% vs 45.5%; odds ratio (OR) 4.16; [2.58; 6.73]; P<0.0001)1 and =<6.5% (54.6% vs 26.2%; OR 3.66; [2.31; 5.81]; P<0.0001)compared with lixisenatide, according to Novo Nordisk.

“The significant difference in blood glucose control between liraglutide and lixisenatide reported in the LIRA-LIXI trial reinforces the value of liraglutide as an efficacious treatment for those with type 2 diabetes otherwise treated with oral glucose-lowering drugs,” said Professor Michael A Nauck, director and diabetologist, Division of Diabetology, St. Josef Hospital, Ruhr-University Bochum, Germany and principal investigator of the LIRA-LIXI trial. “Many people living with type 2 diabetes remain uncontrolled and it is crucial for these patients to gain control of their blood glucose levels to help prevent further complications from this disease.”

Furthermore, Victoza demonstrated significantly greater reductions in fasting plasma glucose (-2.85 mmol/L vs -1.70 mmol/L; ETD -1.15 mmol/L [95% CI -1.51; -0.80]; P<0.0001) and mean 9-point self-measured plasma glucose (-2.64 mmol/L vs. -1.89 mmol/L; ETD -0.75 mmol/L [95% CI -1.08; -0.42]; P<0.0001) compared with lixisenatide.1 Lixisenatide had a smaller postprandial increment for the meal following the injection compared to Victoza (morning meal: -2.12 mmol/L vs -0.88 mmol/L; ETD 1.24 mmol/L; [0.69; 1.79]; P<0.000 for those injecting lixisenatide in the morning; and evening meal: -1.88 mmol/L vs -0.53 mmol/L; ETD 1.36 mmol/L; [0.44; 2.27]; P=0.0039 for those injecting lixisenatide in the evening). There was no difference at the other meals of the day, leading to similar overall postprandial glucose control across all meals for lixisenatide and Victoza.

Weight loss was observed in both treatment groups (Victoza: -4.26 kg vs lixisenatide:   -3.67 kg; ETD -0.59 kg [-1.55; 0.38]; P=0.2347).1 Systolic and diastolic blood pressure decreased with both Victoza and lixisenatide treatment (systolic blood pressure: -4.70 mmHg vs -3.49 mmHg; ETD -1.21 mmHg [-3.87; 1.45]; P=0.3722; diastolic blood pressure: -2.62 mmHg vs -2.69 mmHg; ETD 0.07 mmHg [-1.53; 1.67]; P=0.9318, respectively).

The safety profile in the LIRA-LIXI trial was similar between the two treatment groups. The most common adverse events were gastrointestinal, which included nausea and diarrhoea. No severe hypoglycaemic episodes were reported.

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