Comparison of liraglutide versus other incretin‐related anti‐hyperglycaemic agents

Mar 13, 2012Diabetes, obesity & metabolism

Comparing liraglutide with other similar diabetes medicines

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Abstract

GLP-1 receptor agonists are associated with greater glycaemic improvements compared to DPP-4 inhibitors.

DPP-4 inhibitors lower plasma glucose levels in a glucose-dependent manner with a low risk of hypoglycaemia.
GLP-1 receptor agonists can lead to significant weight loss and may reduce blood pressure.
Both classes of medications are generally well tolerated, but DPP-4 inhibitors may lead to infections and headaches.
GLP-1 receptor agonists are often linked to gastrointestinal disorders, particularly nausea.
Pancreatitis has been reported with both treatment classes, though a causal relationship has not been established.

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The two classes of incretin-related therapies, dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), have become important treatment options for patients with type 2 diabetes. Sitagliptin, saxagliptin, vildagliptin and linagliptin, the available DPP-4 inhibitors, are oral medications, whereas the GLP-1 RAs-twice-daily exenatide, once-weekly exenatide and once-daily liraglutide-are administered subcutaneously. By influencing levels of GLP-1 receptor stimulation, these medications lower plasma glucose levels in a glucose-dependent manner with low risk of hypoglycaemia, affecting postprandial plasma glucose more than most other anti-hyperglycaemic medications. Use of GLP-1 RAs has been shown to result in greater glycaemic improvements than DPP-4 inhibitors, probably because of higher levels of GLP-1 receptor activation. GLP-1 RAs can also produce significant weight loss and may reduce blood pressure and have beneficial effects on other cardiovascular risk factors. Although both classes are well tolerated, DPP-4 inhibitors may be associated with infections and headaches, whereas GLP-1 RAs are often associated with gastrointestinal disorders, primarily nausea. Pancreatitis has been reported with both DPP-4 inhibitors and GLP-1 RAs, but a causal relationship between use of incretin-based therapies and pancreatitis has not been established. In clinical trials, liraglutide has shown efficacy and tolerability and resulted in certain significant benefits when compared with exenatide and sitagliptin.

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Comparison of liraglutide versus other incretin‐related anti‐hyperglycaemic agents

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