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Liraglutide in an Arab population.

Liraglutide lowers weight and HbA1c in T2DM Arab patients

The first trial ever conducted to specifically look at the efficacy of liraglutide in Arab population.

Liraglutide is effective in reducing weight, HbA1c as well as other metabolic parameters in Arab population with type2 diabetes, according to a study 'Liraglutide effect in reducing Hba1c and weight in Arab population with type2 diabetes, a prospective observational trial', published in the Journal of Diabetes & Metabolic Disorders. The investigators from the United Arab Emirates said that they believed this was the first trial ever conducted to specifically look at the efficacy of liraglutide in Arab population.

It is known that pathophysiology of type2 diabetes differs between different ethnic groups, and that Asians develop type2 diabetes at younger age, lower body mass index and in relatively short time. In addition, some ethnicities have different responses and dosing regimens to different classes of anti-diabetic agents. For example, data from Japanese population showed that the optimal doses of liraglutide used are smaller than other populations and that weight loss is not as effective as seen in Caucasians.

As a result, the researchers assessed the efficacy of liraglutide in reducing weight and HbA1c in Arab population when used as add on to other anti-diabetic agents. They prospectively followed patients who were recruited to treatment with liraglutide for a six months period. Patients were checked at three months and at the end of the study at six months.

The dose of liraglutide started at 0.6mg once per day subcutaneously and increased after one week to 1.2mg and after another week to 1.8mg per day. Those who did not tolerate the 1.2mg were excluded from the study, while those who did not tolerate the 1.8mg were advised to continue with 1.2mg per day (1.2–1.8mg were the doses used in LEAD trials).

Outcomes

A total of 365 patients were recruited to the study and at baseline the mean weight was 96.01±19.2kg; after 3 months of starting liraglutide the mean weight reduction was highly significant; 94.8±20kg with (p<0.001)) and a percentage change of 2.01±0.3kg. At six months the mean weight was 94.5±19kg with (p<0.001) and percentage change of 2.5±0.6kg; this was again highly significant. The change in weight was significant even when data was adjusted for age, gender, medications, and comorbidities (Figure 1).

Figure 1: Changes in the body weight in kg among the studied cases

Change in HbA1c was highly significant, with a change from baseline of 8.3±1.7 to 7.7±1.4 % (p<0.001), and 7.6+1.6 % (p<0.001) at three and six months respectively. Change in HbA1c was highly significant even after correction for age, gender, medications and comorbidities (Figure 2).

Figure 2: Changes in HBA1C in among the studied cases

There was a highly significant change in the total cholesterol level six months after starting treatment with liraglutide; the total cholesterol level has changed from 165.2±40mg/dl at baseline to 153.6±35mg/dl (p<0.001) at six months. The same findings were seen with triglyceride, which has changed from 142.3±68mg/dl at baseline to 131.4±61mg/dl (p<0.001) at six months (Figure 3).

Figure 3: Changes in Total cholesterol and Triglycerides before and after therapy

There was no significant change in systolic blood pressure at the end of the study. The diastolic blood pressure has dropped on therapy from a mean of 74.4±10mmHg at baseline to 72±9mmHg at six months, this was highly significant with p<0.001. Serum creatinine has changes from 0.77±0.19mg/dl at base line to 0.76±0.2mg/dl at the end of the study. This change was not statistically significant (p=0.10).

“In agreement with all previous trials, the use of liraglutide in our cohort (Arab population) has resulted in a significant reduction in HbA1c that ranged from 0.5 to 1.15 % in HbA1c in 6 months of therapy,” the authors write. “These findings indicate that liraglutide is efficacious in lowering A1c and weight in Arab population and seems to have similar results to other trials in different races…Our study was not designed to look at safety and tolerability of liraglutide, which would have added a lot of value to the study.”

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