A study published in the Lancet has reported that a new weekly injection of the drug Exenatide (Byetta) has proved safe and effective in new research.
Exenatide is already available as a treatment for type 2 diabetes, but currently needs to be self-injected by patients twice daily. The drug increases insulin secretion from the pancreas, slows stomach emptying and also suppresses hormones that would increase glucose production. NICE has tight guidelines for exenatide
prescription.
The new research was carried out by the University of Toronto, the University of North Carolina School of Medicine, and the companies Amylin Pharmaceuticals and Eli Lilly.
It involved a random controlled trial which compared two different formulations of the drug, the established twice daily formulation was compared with a new, long-acting formulation which is only given once per week.
The trials involved 295 participants over 30 weeks with each individual being assigned to one group or the other. During the trial their blood sugar levels were monitored as well as any side-effects from the drugs. At the start and end of the trial HbA1c levels were measured.
The researchers found that at 30 weeks, the once-weekly Exenatide formulation had reduced HbA1c levels more than the twice-daily formulation, a reduction of about 1.9 percent compared to a reduction of about 1.5 percent. This represented a greater reduction of HbA1c levels by about 0.3 percent.
In the once-weekly Exenatide group, 77 percent of participants achieved this target, compared with 61 percent of participants in the twice-daily Exenatide group. There was no difference in change in bodyweight between the groups. There was also no difference between the groups in episodes of hypoglycaemia, with no serious episodes in either group.
About 6 percent of the once-weekly group withdrew from the study due to side effects, compared with 5 percent in the twice-daily group.
This trial gives encouraging results for the once-weekly Exenatide formulation but further long-term studies will be needed to investigate the long-term efficacy and safety of this treatment compared with other forms of treatment for type 2 diabetes.
Exenatide is currently not licensed for use on its own in type 2 diabetes and does not replace all other diabetes
treatments, and is only taken alongside first-line diabetes medications which have controlled blood sugar levels
poorly.