Once-Monthly Exenatide Improved Glucose Control in Patients with Type 2 Diabetes: Phase 2 Study Results Presented at ADA 2011
The 121-patient study assessed the efficacy, safety and tolerability of three different doses (5 mg, 8 mg and 11 mg) of exenatide once monthly, a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist. After 20 weeks of treatment (total of five injections), patients receiving exenatide once monthly experienced average improvements in A1C (a measure of average blood sugar over three months) from baseline of 1.3 percentage points for the 5 mg and 8 mg doses and 1.5 percentage points for the 11 mg dose. In addition, 50 percent of those treated with the 5 mg dose, 57 percent treated with the 8 mg dose and 70 percent treated with the 11 mg dose achieved an A1C of less than 7 percent, the ADA-recommended target for good glucose control. Patients also lost a modest amount of weight (0.9 pounds with the 8 mg dose and 2.4 pounds with the 5 mg and 11 mg doses), although exenatide once monthly is not being studied as a weight-loss product. Fasting plasma glucose was improved with all doses, with reductions of 25 mg/dL with the 5 mg dose, 30 mg/dL with the 8 mg dose and 49 mg/dL with the 11 mg dose. The mean pharmacokinetic profile showed all three exenatide once monthly doses resulted in steady-state exenatide plasma levels within the known therapeutic range.
As a reference arm, the study also included patients receiving BYDUREON™ (exenatide extended-release for injectable suspension), another investigational form of exenatide that is dosed once-weekly. Results for A1C, fasting glucose and weight in the exenatide once monthly treatment arms were generally comparable to those seen in the BYDUREON reference arm. Patients receiving BYDUREON experienced reductions in A1C (1.5 percentage points), fasting plasma glucose (34 mg/dL) and weight (3.1 pounds) compared to baseline.
"Our exenatide suspension program builds upon our extensive experience and knowledge gained throughout the development of BYETTA and BYDUREON, and suggests promise in harnessing the therapeutic potential of continuous GLP-1 agonism in a monthly dose," said
More than 90 percent of patients completed the study. The most common adverse events within the exenatide once monthly treatment groups were headache (17-27 percent) and nausea (17-23 percent). Headache (30 percent) and diarrhea (27 percent) were most common among the BYDUREON group. No major or minor hypoglycemia was reported in the study. The duration of adverse events was generally similar between treatment groups.
Exenatide once monthly is an investigational, extended-release formulation of exenatide, the active ingredient in BYETTA® (exenatide) injection, which is given twice daily. Exenatide once monthly is based on the same microsphere technology used in BYDUREON. BYDUREON is the proposed brand name for exenatide extended-release for injectable suspension, an investigational medication for type 2 diabetes designed to deliver continuous therapeutic levels of exenatide in a single weekly dose. BYDUREON received marketing authorization in the
Study Design
This phase 2, randomized, open-label, dose-ranging study included 121 adults with type 2 diabetes (baseline A1C: 8.6 percent for BYDUREON and 8.4-8.5 percent for exenatide once monthly) who were not achieving adequate glucose control using diet and exercise alone or with a stable regimen of metformin, Actos® (pioglitazone) or both. Subjects were randomized to receive either 2 mg weekly subcutaneous injections of BYDUREON or subcutaneous injections of exenatide once monthly at a low (5 mg), medium (8 mg) or high (11 mg) dose administered once every four weeks for 20 weeks.
About Diabetes
Diabetes affects nearly 26 million people in the U.S. and an estimated 285 million adults worldwide.(i)(ii) Approximately 90-95 percent of those affected have type 2 diabetes. Diabetes costs more than
According to the
About BYETTA® (exenatide) injection
BYETTA was the first glucagon-like peptide-1 (GLP-1) receptor agonist to be approved by the
BYETTA is an injectable prescription medicine that may improve blood sugar (glucose) control in adults with type 2 diabetes mellitus, when used with a diet and exercise program. BYETTA is not insulin and should not be taken instead of insulin. BYETTA is not currently recommended to be taken with insulin. BYETTA is not for people with type 1 diabetes or people with diabetic ketoacidosis. BYETTA has not been studied in people who have pancreatitis.
BYETTA provides sustained A1C control and low incidence of hypoglycemia when used alone or in combination with metformin or a thiazolidinedione, with potential weight loss (BYETTA is not a weight-loss product). BYETTA was approved in the U.S. in
Important Safety Information for BYETTA® (exenatide) injection
Based on postmarketing data BYETTA has been associated with acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis. Patients should be observed for signs and symptoms of pancreatitis after initiation or dose escalation of BYETTA. The risk for getting low blood sugar is higher if BYETTA is taken with another medicine that can cause low blood sugar, such as a sulfonylurea. BYETTA should not be used in people who have severe kidney problems and should be used with caution in people who have had a kidney transplant. Patients should talk with their healthcare provider if they have severe problems with their stomach, such as delayed emptying of the stomach (gastroparesis) or problems with digesting food. Antibodies may develop with use of BYETTA. Patients who develop high titers to exenatide could have worsening or failure to achieve adequate glycemic control. Consider alternative therapy if this occurs. Severe allergic reactions can happen with BYETTA. There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with BYETTA or any other antidiabetic drug.
The most common side effects with BYETTA include nausea, vomiting, diarrhea, dizziness, headache, feeling jittery, and acid stomach. Nausea most commonly happens when first starting BYETTA, but may become less over time.
These are not all the side effects from use of BYETTA. A healthcare provider should be consulted about any side effect that is bothersome or does not go away.
For additional important safety information about BYETTA, please see the full Prescribing Information (www.byetta.com/pi) and Medication Guide (www.byetta.com/mg).
About Amylin, Lilly and
Amylin and Lilly partnered to develop and market BYDUREON, which is based on proprietary technology for long-acting medications developed by
Through a long-standing commitment to diabetes care, Lilly provides patients with breakthrough treatments that enable them to live longer, healthier and fuller lives. Since 1923, Lilly has been the industry leader in pioneering therapies to help healthcare professionals improve the lives of people with diabetes, and research continues on innovative medicines to address the unmet needs of patients.
Lilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in
This press release contains forward-looking statements about Amylin, Lilly and
BYDUREON™ and BYETTA® are trademarks of
P-LLY
(i) Diabetes Statistics.
(ii) The International Diabetes Federation Diabetes Atlas. Available at: http://www.diabetesatlas.org/content/some-285-million-people-worldwide-will-live-diabetes-2010. Accessed
(iii) Direct and Indirect Costs of Diabetes in
(iv) Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes.
(v) Bays HE, Chapman RH, Grandy S. The relationship of body mass index to diabetes mellitus, hypertension and dyslipidaemia: comparison of data from two national surveys. Int J Clin Pract. 2007;61:737-47.
(vi) Nutrition Recommendations and Interventions for Diabetes: a position statement of the
(vii) Anderson JW, Kendall CW, Jenkins DJ. Importance of weight management in type 2 diabetes: review with meta-analysis of clinical studies. J Am Coll Nutr. 2003;22:331-9.
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