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Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1) Featured Article: Carol Wysham, Thomas Blevins, Richard Arakaki, Gildred Colon, Pedro Garcia, Charles Atisso, Debra Kuhstoss, and Mark Lakshmanan Diabetes Care Volume 37: 2159-2 167 August, 2014

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Page 1: Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in

Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

Featured Article:

Carol Wysham, Thomas Blevins, Richard Arakaki, Gildred Colon,Pedro Garcia, Charles Atisso, Debra Kuhstoss, and Mark Lakshmanan

Diabetes Care Volume 37: 2159-2167

August, 2014

Page 2: Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

STUDY OBJECTIVE 

• To compare the efficacy and safety of dulaglutide with placebo and exenatide in type 2 diabetic patients

• To determine superiority of dulaglutide 1.5 mg versus placebo in HbA1c change at 26 weeks

Wysham C. et al. Diabetes Care 2014;37:2159-2167

Page 3: Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

STUDY DESIGN AND METHODS

• Study randomized patients to dulaglutide 1.5 mg, dulaglutide 0.75 mg, exenatide 10 mg, or placebo

• Patients were treated with metformin (1,500–3,000 mg) and pioglitazone (30–45 mg)

• Mean baseline HbA1c was 8.1%

Wysham C. et al. Diabetes Care 2014;37:2159-2167

Page 4: Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

Wysham C. et al. Diabetes Care 2014;37:2159-2167

Page 5: Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

RESULTS

• Least squares mean ± SE HbA1c change from baseline to primary end point was:

• • 21.51 ± 0.06% for dulaglutide 1.5 mg• • 21.30 ± 0.06% for dulaglutide 0.75 mg• • 20.99 ± 0.06% for exenatide• • 20.46 ± 0.08% for placebo

• Both dulaglutide doses were superior to placebo at 26 weeks and exenatide at 26 and 52 weeks

• Greater percentages of patients reached HbA1c targets with dulaglutide 1.5 mg and 0.75 mg than with placebo and exenatide

Wysham C. et al. Diabetes Care 2014;37:2159-2167

Page 6: Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

RESULTS

• At 26 and 52 weeks, total hypoglycemia incidence was lower in patients receiving dulaglutide 1.5 mg than in those receiving exenatide

• No dulaglutide-treated patients reported severe hypoglycemia

• Most common gastrointestinal adverse events for dulaglutide were nausea, vomiting, and diarrhea

• Events were mostly mild to moderate and transient

Wysham C. et al. Diabetes Care 2014;37:2159-2167

Page 7: Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

Wysham C. et al. Diabetes Care 2014;37:2159-2167

Page 8: Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

Wysham C. et al. Diabetes Care 2014;37:2159-2167

Page 9: Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

Wysham C. et al. Diabetes Care 2014;37:2159-2167

Page 10: Efficacy and Safety of Dulaglutide Added Onto Pioglitazone and Metformin Versus Exenatide in Type 2 Diabetes in a Randomized Controlled Trial (AWARD-1)

CONCLUSIONS

• Both once-weekly dulaglutide doses demonstrated superior glycemic control versus placebo and exenatide with an acceptable tolerability and safety profile

Wysham C. et al. Diabetes Care 2014;37:2159-2167