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Efficacy of liraglutide on glycemic endpoints in people of Western European and South Asian descent with T2DM using multiple daily insulin injections: results of the MAGNA VICTORIA studies

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Abstract

Aims

Data on the effect of liraglutide on glycemic endpoints in people with T2DM using multiple daily insulin injections (MDI) are scarce, especially in the context of ethnicity.

Methods

This is a secondary analysis of the placebo-controlled randomized clinical “MAGNA VICTORIA” trials in Western European (WE) and South Asian (SA) people with T2DM. Participants had inadequate glycemic control despite using metformin and/or sulfonylurea derivatives and/or insulin. Participants were assigned to liraglutide (1.8 mg) or placebo for 6 months, in addition to standard care. The primary endpoint number of participants reaching target HbA1c was compared for liraglutide versus placebo in the complete dataset and MDI-treated participants using Chi-square test. Liraglutide’s efficacy in WE and SA was compared using a generalized linear model.

Results

Forty-five subjects were randomized to liraglutide and 51 to placebo. In each group, one participant did not complete the study. Liraglutide-treated patients reached target HbA1c more frequently: 23/45 (51%) vs 11/51 (22%), relative probability 2.4 (1.3–4.3), p = 0.002. Subgroup analysis in 43 MDI participants showed that the proportion reaching target HbA1c using liraglutide was significantly higher than in placebo: 9/22 (41%) vs 1/21 (5%), p = 0.005. There was no difference between WE and SA in terms of liraglutide efficacy (p = 0.18).

Conclusions

Liraglutide treatment resulted in increased chance of reaching target HbA1c as compared to placebo. Liraglutide efficacy was sustained in participants using MDI regimens and those of SA descent. Liraglutide should be considered for T2DM people with inadequate glycemic control despite MDI.

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Acknowledgements

We are grateful to all members of the MAGNA VICTORIA study group (see supplemental material) who assisted in recruitment of participants. We thank Mrs. B. Ladan-Eygenraam (Department of Internal Medicine, Leiden University Medical Center, The Netherlands) for assistance in the laboratory.

Funding

M.B. Bizino, H.J. van Eyk, P.C.N. Rensen, P.H. Geelhoed-Duijvestijn, A.V. Kharaghjitsing, E.H.M. Paiman, J.W. Smit, H.J. Lamb: No funding received. I.M. Jazet: unrestricted grant from Roba Metals B.V. IJsselstein (Utrecht, The Netherlands).

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Authors and Affiliations

  1. Department of Radiology, Leiden University Medical Center, LUMC Postzone C2S, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands

    Maurice B. Bizino, Elisabeth H. M. Paiman & Hildebrandus J. Lamb

  2. Department of Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

    Ingrid M. Jazet, Huub J. van Eyk, Patrick C. N. Rensen & Aan V. Kharagjitsingh

  3. Department of Medicine, Haaglanden Medical Center, The Hague, The Netherlands

    Petronella H. Geelhoed-Duijvestijn

  4. Department of Medicine, Radboud University Medical Center, Nijmegen, The Netherlands

    Johannes W. Smit

  5. Department of Diabetology and Endocrinology and Diabetes Research Center, Vrije Universiteit Brussel, Brussels, Belgium

    Aan V. Kharagjitsingh

Authors
  1. Maurice B. Bizino
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  2. Ingrid M. Jazet
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  3. Huub J. van Eyk
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  7. Elisabeth H. M. Paiman
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  8. Johannes W. Smit
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  9. Hildebrandus J. Lamb
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Corresponding author

Correspondence to Maurice B. Bizino.

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Conflict of interest

I.M. Jazet received an unrestricted grant form Roba Metals B.V. IJsselstein (Utrecht, The Netherlands). All authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Leiden University Medical Center Medical Ethics Committee: Commissie Medische Ethiek. Tthe study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The MAGNA VICTORIA studies have been registered prospectively: NCT01761318 (January 4, 2013) and NCT02660047 (October 13, 2016).

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Written informed consent was obtained from all participants before study.

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Bizino, M.B., Jazet, I.M., van Eyk, H.J. et al. Efficacy of liraglutide on glycemic endpoints in people of Western European and South Asian descent with T2DM using multiple daily insulin injections: results of the MAGNA VICTORIA studies. Acta Diabetol 58, 485–493 (2021). https://doi.org/10.1007/s00592-020-01635-0

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