Real-world clinical outcomes and predictors of glycaemic and weight response to exenatide once weekly in patients with type 2 diabetes: The CIBELES project.

Autor:	Gorgojo-Martínez JJ; Unit of Endocrinology and Nutrition, Hospital Universitario Fundación Alcorcón, Madrid, Spain., Gargallo-Fernández MA; Department of Endocrinology and Nutrition, Hospital Universitario Infanta Leonor, Madrid, Spain., Brito-Sanfiel M; Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro, Madrid, Spain., Lisbona-Catalán A; Department of Endocrinology and Nutrition, Hospital Universitario La Paz, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	International journal of clinical practice [Int J Clin Pract] 2018 Mar; Vol. 72 (3), pp. e13055. Date of Electronic Publication: 2018 Jan 17.
DOI:	10.1111/ijcp.13055
Abstrakt:	Aims: To evaluate in a real-world setting the effectiveness of exenatide once-weekly (ExQW) in patients with T2D and to determine predictors of glycaemic and weight response to this drug at 6 months. Methods: Observational, retrospective, multicenter study in adult patients with T2D and BMI ≥30 kg/m 2 from 4 tertiary Spanish hospitals who started ExQW therapy at least 6 months before the inclusion and had not achieved adequate glycaemic control on oral therapies or other GLP-1 receptor agonists. Glycaemic response was defined as an A1C reduction ≥1.0% and weight response as a weight loss ≥3% 6 months after ExQW. The best predictive models of glycaemic and weight response were estimated by binary logistic regression. Results: One hundred and forty eight patients were included, mean age 58.0 years, A1C 7.7%, weight 105.9 kg and BMI 38.4 kg/m 2 . A1C (-1.1%), weight (-3.9 kg), systolic blood pressure (-4.0 mm Hg), diastolic blood pressure (-2.9 mm Hg), LDL-cholesterol (-14.2 mg/dL) and triglycerides (-31.0 mg/dL) significantly decreased 6 months after ExQW. 41.5% of patients had an A1C reduction ≥1.0% and 53.1% lost ≥3% of baseline weight. Glycaemic and weight reductions were sustained in patients completing 1 and 2 years of follow-up. The best predictive model of glycaemic response only included higher A1C levels (OR 3.9), whereas higher BMI (OR 1.1) and prior DPP-4i therapy (OR 3.1) were associated to weight response in the multivariate analysis. Conclusions: In a real-world setting, ExQW significantly decreased A1C, weight, blood pressure and lipids at 6 months. Our study identified higher baseline A1C as the sole independent predictor of glycaemic response to ExQW and higher BMI and previous DDP4i treatment as predictive factors of meaningful weight response. (© 2018 John Wiley & Sons Ltd.)
Databáze:	MEDLINE
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