Pharmacology, efficacy and safety of liraglutide in the management of type 2 diabetes

Joshua J Neumiller¹, Travis E Sonnett², Lindy D Wood¹, Stephen M Setter1, R Keith Campbell<sup>2

1</sup>Department of Pharmacotherapy, College of Pharmacy, Washington State University, Spokane, Washington; ²Department of Pharmacotherapy, College of Pharmacy, Washington State University, Pullman, Washington, USA

Abstract: Liraglutide is a glucagon-like peptide-1 analog with pharmacokinetic properties suitable for once-daily administration approved by the Food and Drug Administration for the treatment of patients with type 2 diabetes. Clinical trial data from large, controlled studies ­demonstrate the safety and efficacy of liraglutide in terms of hemoglobin A_1c (HbA_1c) reduction, reductions in body weight, and the drug’s low risk for hypoglycemic events when used as monotherapy. ­Liraglutide has been studied as monotherapy and in combination with metformin, glimepiride, and ­rosiglitazone for the treatment of type 2 diabetes. Additionally, comparative data with insulin glargine and exenatide therapy are available from Phase III trials. Once-daily ­administration may provide a therapeutic advantage for liraglutide over twice-daily exenatide, with similar improvements in HbA_1c and body weight observed when liraglutide was compared with exenatide. The glucose-dependent mechanism of insulin release with incretin analog therapy holds potential clinical significance in the management of postprandial hyperglycemic excursions, with minimal risk of hypoglycemia when used with non-secretagogue medications. Data to date on patient-reported outcomes with liraglutide treatment are encouraging. The most common adverse events associated with liraglutide therapy are dose-dependent nausea, vomiting, and diarrhea. Diligent postmarketing surveillance to elucidate the risk of pancreatitis and medullary thyroid carcinoma in a heterogeneous population are likely warranted.

Keywords: incretin analog, incretin effect, liraglutide, diabetes