exenatide and Nasopharyngitis

To systematically review the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on two common respiratory system adverse events (RSAE: nasopharyngitis and upper respiratory tract infection) among type 2 diabetes (T2DM).. Medline, Embase, Clinical trials and Cochrane library were searched from inception through May 2015 to identify randomized clinical trials(RCTs) assessed safety of GLP-1RAs versus placebo or other anti-diabetic drugs in T2DM. Network meta-analysis within a Bayesian framework was performed to calculate odds ratios for the incidence of RSAE.. In the study, 50 RCTs were included, including 13 treatments: 7 GLP-1RAs (exenatide, exenatide-long-release-agent, liraglutide, lixisenatide, taspoglutide, albiglutide and dulaglutide), placebo and 5 traditional anti-diabetic drugs(insulin, metformin, sulfonylureas, sitagliptin and thiazolidinediones ketones). Compared with insulin, taspoglutide significantly decreased the incidence of nasopharyngitis (OR=0.67, 95%CI: 0.46-0.96). Significant lowering effects on upper respiratory tract infection were found when taspoglutide versus placebo (OR=0.57, 95%CI: 0.34-0.99) and insulin (OR=0.39, 95%CI: 0.23-0.73). The result from the network meta-analysis based on Bayesian theory could be used to rank all the treatments included, which showed that taspoglutide ranked last with minimum risk on nasopharyngitis and upper respiratory tract infection.. Taspoglutide was associated with significantly lowering effect on RSAE.

Topics: Bayes Theorem; Diabetes Mellitus, Type 2; Exenatide; Glucagon-Like Peptide 1; Glucagon-Like Peptide-1 Receptor; Glucagon-Like Peptides; Humans; Hypoglycemic Agents; Immunoglobulin Fc Fragments; Insulin; Liraglutide; Metformin; Nasopharyngitis; Peptides; Randomized Controlled Trials as Topic; Recombinant Fusion Proteins; Respiratory Tract Infections; Thiazolidinediones; Venoms

Patient numbers in individual diabetes trials are often too limited to assess the effect of a treatment by different patient characteristics, and meta-analyses often do not include patient-level data. The purpose of this pooled analysis was to evaluate the efficacy and tolerability of exenatide once weekly (EQW) in patients with type 2 diabetes grouped into subpopulations by key demographic characteristics.. This post hoc analysis included data from patients who received EQW in seven randomised, controlled phase 3 trials that were 24-30 weeks in duration. Patients were classified into subpopulations on the basis of their baseline age (< 65 or ≥ 65 years), gender (male or female), race (White, Black, Asian, Hispanic), duration of diabetes (< 10 years, ≥ 10 years) and body mass index (BMI; < 25, ≥ 25 to < 30, ≥ 30 to < 35, ≥ 35 to < 40 or ≥ 40 kg/m(2)).. A total of 1719 patients were included in this analysis of patient subpopulations. All subpopulations experienced significant improvements from baseline in haemoglobin A1C, fasting glucose and body weight. Most subpopulations experienced significant improvements in blood pressure and lipid parameters. Overall, the most common AEs were hypoglycaemia (16.4% overall; 2.3% in patients not on concomitant sulfonylurea), nausea (14.7%), diarrhoea (10.9%) and nasopharyngitis (7.2%).. These results show that the treatment of type 2 diabetes with EQW for 24-30 weeks was associated with significant improvements in glycaemic control and body weight, irrespective of age, gender, race, duration of diabetes or BMI. The most common adverse events were gastrointestinal in nature.

Topics: Blood Glucose; Blood Pressure; Body Mass Index; Clinical Trials, Phase III as Topic; Diabetes Mellitus, Type 2; Diarrhea; Drug Administration Schedule; Exenatide; Female; Glycated Hemoglobin; Humans; Hypoglycemia; Hypoglycemic Agents; Lipid Metabolism; Male; Middle Aged; Nasopharyngitis; Nausea; Peptides; Randomized Controlled Trials as Topic; Treatment Outcome; Venoms