Imperial College London
Alternate

Professor Neil Poulter

Faculty of Medicine, School of Public Health

Professor of Preventive Cardiovascular Medicine.
 
 
 
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Contact

 

+44 (0)20 7594 3446n.poulter

 
 
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Assistant

 

Mrs Ranjit Rayat +44 (0)20 7594 3445

 
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Location

 

55Stadium HouseWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Tack:2019:10.1111/dom.13826,
author = {Tack, CJ and Jacob, S and Desouza, C and Bain, SC and Buse, JB and Nauck, MA and Petrie, JR and Poulter, NR and Pratley, RE and Stegmann, HVBK and Bosch-Traberg, H and Startseva, E and Zinman, B and LEADER, Publication Committee on behalf of the LEADER Trial Investigators},
doi = {10.1111/dom.13826},
journal = {Diabetes, Obesity and Metabolism: a journal of pharmacology and therapeutics},
pages = {2450--2458},
title = {Long-term efficacy and safety of combined insulin and glucagon-like peptide-1 therapy: Evidence from the LEADER trial},
url = {http://dx.doi.org/10.1111/dom.13826},
volume = {21},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AIM: Glucagon-like peptide-1 receptor agonist (GLP-1RA) and insulin combination therapy is an effective treatment option for type 2 diabetes, but long-term data are lacking. The aim was to assess the long-term efficacy of the GLP-1RA liraglutide in subgroups by insulin use in the LEADER trial. MATERIALS AND METHODS: LEADER assessed cardiovascular (CV) safety and efficacy of liraglutide (1.8 mg) versus placebo (plus standard of care therapy) in 9340 patients with type 2 diabetes and high risk of CV disease, for up to 5 years. We analyzed CV events, metabolic parameters and hypoglycaemia post hoc in three subgroups by baseline insulin use (basal-only insulin, other insulin or no insulin). Insulin was a non-random treatment allocation as part of standard of care therapy. RESULTS: At baseline, 5171 (55%) patients were not receiving insulin, 3159 (34%) were receiving basal-only insulin and 1010 (11%) other insulins. Insulin users had a longer diabetes duration and slightly worse glycaemic control (HbA1c) than the no-insulin subgroup. Liraglutide reduced HbA1c and weight versus placebo in all three subgroups (P < .001), and severe hypoglycaemia rate in the basal-only insulin subgroup. The need for insulin was less with liraglutide. CV risk reduction with liraglutide was similar to the main trial results in the basal-only and no-insulin subgroups. CONCLUSIONS: In patients on insulin, liraglutide improved glycaemic control, weight and need for insulin versus placebo, for at least 36 months with no increased risk of severe hypoglycaemia, while maintaining CV safety/efficacy, supporting the combination of liraglutide and insulin for management of type 2 diabetes.
AU  - Tack,CJ
AU  - Jacob,S
AU  - Desouza,C
AU  - Bain,SC
AU  - Buse,JB
AU  - Nauck,MA
AU  - Petrie,JR
AU  - Poulter,NR
AU  - Pratley,RE
AU  - Stegmann,HVBK
AU  - Bosch-Traberg,H
AU  - Startseva,E
AU  - Zinman,B
AU  - LEADER,Publication Committee on behalf of the LEADER Trial Investigators
DO  - 10.1111/dom.13826
EP  - 2458
PY  - 2019///
SN  - 1462-8902
SP  - 2450
TI  - Long-term efficacy and safety of combined insulin and glucagon-like peptide-1 therapy: Evidence from the LEADER trial
T2  - Diabetes, Obesity and Metabolism: a journal of pharmacology and therapeutics
UR  - http://dx.doi.org/10.1111/dom.13826
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31282028
UR  - https://onlinelibrary.wiley.com/doi/full/10.1111/dom.13826
UR  - http://hdl.handle.net/10044/1/73396
VL  - 21
ER  -
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