AACE 2011

SAN DIEGO – Women with nontoxic goiter were more than twice as likely to have breast cancer, compared with women in the general population, according to a review of data from 789 women with nontoxic, multinodular goiter, uninodular goiter, or simple goiter.

The findings were presented at the annual meeting of the American Association of Clinical Endocrinologists.

Data from previous studies of a potential link between thyroid disorders and breast cancer are inconclusive, said Sarika Patel Sanghvi, D.O., of Robert Wood Johnson Medical School in New Brunswick, N.J.

In this study, Dr. Sanghvi and her colleagues compared breast cancer incidence in women with nontoxic goiter with breast cancer incidence in the general population of New Jersey. Breast cancer history was obtained from each patient’s medical history.

Overall, 28 of 789 women with goiter also had breast cancer, for a prevalence of 3.6%. By contrast, the prevalence of breast cancer in the general population, based on data from the New Jersey Department of Health and Senior Services, was significantly lower at 1.6%.

Two of the 28 patients with breast cancer had low TSH levels, but one had a free T4 within normal limits and the other had a total T4 within normal limits, said Dr. Sanghvi. Four of the 28 patients had serum thyroid peroxidase (TPO) antibodies, only one level of which was elevated, but this patient had normal TSH and free T4 levels, Dr. Sanghvi said.

The association between breast cancer and nontoxic goiter is unclear, she said. Possible mechanisms include the role of iodine, thyroid-stimulating hormone, and estrogen.

"Iodine has been theorized as being a causative factor, because it is utilized by both breast and thyroid tissues," and these are the only two organs in which iodine is stored. Dr. Sanghvi explained. However, epidemiologic studies are needed to explore the association between iodine and breast cancer, she said.

The results were limited by the retrospective nature of the study, and the lack of a standard medical history questionnaire. But they underscore the important of breast cancer screening in women with benign thyroid disease until larger, prospective studies provide additional information, Dr. Sanghvi said.

In the study population as a whole, the average age was 51 years, the average body mass index was 29.2 kg/m², the average TSH was 2.02 mIU/L, and the average free T4 was 1.67 ng/dL. Among the 28 patients with a family history of breast cancer, the average age was 57 years, the average BMI was 29 kg/m², the average TSH was 1.54 mIU/L, and the average free T4 was 1.14 ng/dL

One of the patients with breast cancer had ductal carcinoma in situ; the breast cancer types in the other 27 patients were not specified.

Dr. Sanghvi reported having no financial conflicts to disclose.

SAN DIEGO – Women with nontoxic goiter were more than twice as likely to have breast cancer, compared with women in the general population, according to a review of data from 789 women with nontoxic, multinodular goiter, uninodular goiter, or simple goiter.

The findings were presented at the annual meeting of the American Association of Clinical Endocrinologists.

Data from previous studies of a potential link between thyroid disorders and breast cancer are inconclusive, said Sarika Patel Sanghvi, D.O., of Robert Wood Johnson Medical School in New Brunswick, N.J.

In this study, Dr. Sanghvi and her colleagues compared breast cancer incidence in women with nontoxic goiter with breast cancer incidence in the general population of New Jersey. Breast cancer history was obtained from each patient’s medical history.

Overall, 28 of 789 women with goiter also had breast cancer, for a prevalence of 3.6%. By contrast, the prevalence of breast cancer in the general population, based on data from the New Jersey Department of Health and Senior Services, was significantly lower at 1.6%.

Two of the 28 patients with breast cancer had low TSH levels, but one had a free T4 within normal limits and the other had a total T4 within normal limits, said Dr. Sanghvi. Four of the 28 patients had serum thyroid peroxidase (TPO) antibodies, only one level of which was elevated, but this patient had normal TSH and free T4 levels, Dr. Sanghvi said.

The association between breast cancer and nontoxic goiter is unclear, she said. Possible mechanisms include the role of iodine, thyroid-stimulating hormone, and estrogen.

"Iodine has been theorized as being a causative factor, because it is utilized by both breast and thyroid tissues," and these are the only two organs in which iodine is stored. Dr. Sanghvi explained. However, epidemiologic studies are needed to explore the association between iodine and breast cancer, she said.

The results were limited by the retrospective nature of the study, and the lack of a standard medical history questionnaire. But they underscore the important of breast cancer screening in women with benign thyroid disease until larger, prospective studies provide additional information, Dr. Sanghvi said.

In the study population as a whole, the average age was 51 years, the average body mass index was 29.2 kg/m², the average TSH was 2.02 mIU/L, and the average free T4 was 1.67 ng/dL. Among the 28 patients with a family history of breast cancer, the average age was 57 years, the average BMI was 29 kg/m², the average TSH was 1.54 mIU/L, and the average free T4 was 1.14 ng/dL

One of the patients with breast cancer had ductal carcinoma in situ; the breast cancer types in the other 27 patients were not specified.

Dr. Sanghvi reported having no financial conflicts to disclose.

SAN DIEGO – Women with nontoxic goiter were more than twice as likely to have breast cancer, compared with women in the general population, according to a review of data from 789 women with nontoxic, multinodular goiter, uninodular goiter, or simple goiter.

The findings were presented at the annual meeting of the American Association of Clinical Endocrinologists.

Data from previous studies of a potential link between thyroid disorders and breast cancer are inconclusive, said Sarika Patel Sanghvi, D.O., of Robert Wood Johnson Medical School in New Brunswick, N.J.

In this study, Dr. Sanghvi and her colleagues compared breast cancer incidence in women with nontoxic goiter with breast cancer incidence in the general population of New Jersey. Breast cancer history was obtained from each patient’s medical history.

Overall, 28 of 789 women with goiter also had breast cancer, for a prevalence of 3.6%. By contrast, the prevalence of breast cancer in the general population, based on data from the New Jersey Department of Health and Senior Services, was significantly lower at 1.6%.

Two of the 28 patients with breast cancer had low TSH levels, but one had a free T4 within normal limits and the other had a total T4 within normal limits, said Dr. Sanghvi. Four of the 28 patients had serum thyroid peroxidase (TPO) antibodies, only one level of which was elevated, but this patient had normal TSH and free T4 levels, Dr. Sanghvi said.

The association between breast cancer and nontoxic goiter is unclear, she said. Possible mechanisms include the role of iodine, thyroid-stimulating hormone, and estrogen.

"Iodine has been theorized as being a causative factor, because it is utilized by both breast and thyroid tissues," and these are the only two organs in which iodine is stored. Dr. Sanghvi explained. However, epidemiologic studies are needed to explore the association between iodine and breast cancer, she said.

The results were limited by the retrospective nature of the study, and the lack of a standard medical history questionnaire. But they underscore the important of breast cancer screening in women with benign thyroid disease until larger, prospective studies provide additional information, Dr. Sanghvi said.

In the study population as a whole, the average age was 51 years, the average body mass index was 29.2 kg/m², the average TSH was 2.02 mIU/L, and the average free T4 was 1.67 ng/dL. Among the 28 patients with a family history of breast cancer, the average age was 57 years, the average BMI was 29 kg/m², the average TSH was 1.54 mIU/L, and the average free T4 was 1.14 ng/dL

One of the patients with breast cancer had ductal carcinoma in situ; the breast cancer types in the other 27 patients were not specified.

Dr. Sanghvi reported having no financial conflicts to disclose.

SAN DIEGO – Type 2 diabetes patients achieved greater blood sugar control with once-daily liraglutide injections than with other standard type 2 diabetes medications, according to the findings from a meta-analysis of seven phase III studies. The findings were presented April 14 at the annual meeting of the American Association of Clinical Endocrinologists.

"The progressive nature of type 2 diabetes makes it difficult for any single therapy to be effective long-term," said Dr. Robert Henry of the University of California, San Diego.

Liraglutide (Victoza) was approved by the Food and Drug Administration in January 2010 to treat type 2 diabetes in adults as an adjunct therapy to a healthy diet and exercise.

To further evaluate the impact of liraglutide on blood sugar control, Dr. Henry and his colleagues consolidated data from seven phase III clinical trials and divided the patients into five categories based on their baseline hemoglobin A_1c level: 7.5% or less (651 patients), 7.6%-8.0% (601 patients), 8.1%-8.5% (538 patients), 8.6%-9.0% (432 patients), and greater than 9.0% (607 patients).

The researchers reviewed the mean changes in HbA_1c from baseline to 26 weeks of treatment. Overall, mean hemoglobin A_1c reductions with a once-daily, 1.8-mg dose of liraglutide were greater than the reductions achieved with standard regimens involving exenatide, insulin glargine, glimepiride, rosiglitazone, or sitagliptin.

In particular, HbA_1c levels were significantly reduced in patients with a baseline HbA_1c of 7.5% or less in the liraglutide group compared with all other groups. The mean reductions in HbA_1c for patients on liraglutide ranged from 0.7% in the 7.5% or less category to 1.8% in the greater than 9.0% category. The next best mean reduction in HbA_1c was seen among patients taking two other injectable therapies: insulin glargine and exenatide. Reductions in HbA_1c in patients taking insulin glargine ranged from 0.3% to 1.5%, and HbA_1c reductions in those taking exenatide ranged from 0.4% to 1.3%.

Patients taking sulfonylureas, sitagliptin, or thiazolidinediones showed less improvement from baseline than did patients taking the injectables. The average reduction in patients taking sitagliptin ranged from 0.0% to 1.1%. The average reduction with sulfonylureas ranged from 0.4% to 1.4%, and the average reduction with thiazolidinediones ranged from 0.4% to 0.8%.

Among 348 patients in the liraglutide group with baseline HbA_1c levels of 7.5% or less, 216 (63%) reached the AACE-recommended HbA_1c target of 6.5% or less, compared with less than half (20%-49%) of patients with a baseline HbA_1c of 7.5% or less in the other groups, Dr. Henry noted.

Among 333 patients in the liraglutide group with HbA_1c levels greater than 9.0%, 33 (10%) reached the 6.5% or less target, compared with 4 (12%) of 34 patients in the insulin glargine group and 0%-5% of patients in the other groups.

The study was limited by the use of mean data, which does not account for individual variability, but the results suggest that liraglutide was effective at reducing HbA_1c throughout the baseline HbA_1c spectrum, Dr. Henry said.

The study was sponsored by Novo Nordisk, which manufactures liraglutide. Dr. Henry has received research support from multiple pharmaceutical companies, including Amylin Pharmaceuticals, AstraZeneca, and Novartis. He has served as an adviser or consultant for, and has received consulting fees from, several companies, including Amylin, Eli Lilly, and Novo Nordisk.

SAN DIEGO – Type 2 diabetes patients achieved greater blood sugar control with once-daily liraglutide injections than with other standard type 2 diabetes medications, according to the findings from a meta-analysis of seven phase III studies. The findings were presented April 14 at the annual meeting of the American Association of Clinical Endocrinologists.

"The progressive nature of type 2 diabetes makes it difficult for any single therapy to be effective long-term," said Dr. Robert Henry of the University of California, San Diego.

Liraglutide (Victoza) was approved by the Food and Drug Administration in January 2010 to treat type 2 diabetes in adults as an adjunct therapy to a healthy diet and exercise.

To further evaluate the impact of liraglutide on blood sugar control, Dr. Henry and his colleagues consolidated data from seven phase III clinical trials and divided the patients into five categories based on their baseline hemoglobin A_1c level: 7.5% or less (651 patients), 7.6%-8.0% (601 patients), 8.1%-8.5% (538 patients), 8.6%-9.0% (432 patients), and greater than 9.0% (607 patients).

The researchers reviewed the mean changes in HbA_1c from baseline to 26 weeks of treatment. Overall, mean hemoglobin A_1c reductions with a once-daily, 1.8-mg dose of liraglutide were greater than the reductions achieved with standard regimens involving exenatide, insulin glargine, glimepiride, rosiglitazone, or sitagliptin.

In particular, HbA_1c levels were significantly reduced in patients with a baseline HbA_1c of 7.5% or less in the liraglutide group compared with all other groups. The mean reductions in HbA_1c for patients on liraglutide ranged from 0.7% in the 7.5% or less category to 1.8% in the greater than 9.0% category. The next best mean reduction in HbA_1c was seen among patients taking two other injectable therapies: insulin glargine and exenatide. Reductions in HbA_1c in patients taking insulin glargine ranged from 0.3% to 1.5%, and HbA_1c reductions in those taking exenatide ranged from 0.4% to 1.3%.

Patients taking sulfonylureas, sitagliptin, or thiazolidinediones showed less improvement from baseline than did patients taking the injectables. The average reduction in patients taking sitagliptin ranged from 0.0% to 1.1%. The average reduction with sulfonylureas ranged from 0.4% to 1.4%, and the average reduction with thiazolidinediones ranged from 0.4% to 0.8%.

Among 348 patients in the liraglutide group with baseline HbA_1c levels of 7.5% or less, 216 (63%) reached the AACE-recommended HbA_1c target of 6.5% or less, compared with less than half (20%-49%) of patients with a baseline HbA_1c of 7.5% or less in the other groups, Dr. Henry noted.

Among 333 patients in the liraglutide group with HbA_1c levels greater than 9.0%, 33 (10%) reached the 6.5% or less target, compared with 4 (12%) of 34 patients in the insulin glargine group and 0%-5% of patients in the other groups.

The study was limited by the use of mean data, which does not account for individual variability, but the results suggest that liraglutide was effective at reducing HbA_1c throughout the baseline HbA_1c spectrum, Dr. Henry said.

The study was sponsored by Novo Nordisk, which manufactures liraglutide. Dr. Henry has received research support from multiple pharmaceutical companies, including Amylin Pharmaceuticals, AstraZeneca, and Novartis. He has served as an adviser or consultant for, and has received consulting fees from, several companies, including Amylin, Eli Lilly, and Novo Nordisk.

SAN DIEGO – Type 2 diabetes patients achieved greater blood sugar control with once-daily liraglutide injections than with other standard type 2 diabetes medications, according to the findings from a meta-analysis of seven phase III studies. The findings were presented April 14 at the annual meeting of the American Association of Clinical Endocrinologists.

"The progressive nature of type 2 diabetes makes it difficult for any single therapy to be effective long-term," said Dr. Robert Henry of the University of California, San Diego.

Liraglutide (Victoza) was approved by the Food and Drug Administration in January 2010 to treat type 2 diabetes in adults as an adjunct therapy to a healthy diet and exercise.

To further evaluate the impact of liraglutide on blood sugar control, Dr. Henry and his colleagues consolidated data from seven phase III clinical trials and divided the patients into five categories based on their baseline hemoglobin A_1c level: 7.5% or less (651 patients), 7.6%-8.0% (601 patients), 8.1%-8.5% (538 patients), 8.6%-9.0% (432 patients), and greater than 9.0% (607 patients).

The researchers reviewed the mean changes in HbA_1c from baseline to 26 weeks of treatment. Overall, mean hemoglobin A_1c reductions with a once-daily, 1.8-mg dose of liraglutide were greater than the reductions achieved with standard regimens involving exenatide, insulin glargine, glimepiride, rosiglitazone, or sitagliptin.

In particular, HbA_1c levels were significantly reduced in patients with a baseline HbA_1c of 7.5% or less in the liraglutide group compared with all other groups. The mean reductions in HbA_1c for patients on liraglutide ranged from 0.7% in the 7.5% or less category to 1.8% in the greater than 9.0% category. The next best mean reduction in HbA_1c was seen among patients taking two other injectable therapies: insulin glargine and exenatide. Reductions in HbA_1c in patients taking insulin glargine ranged from 0.3% to 1.5%, and HbA_1c reductions in those taking exenatide ranged from 0.4% to 1.3%.

Patients taking sulfonylureas, sitagliptin, or thiazolidinediones showed less improvement from baseline than did patients taking the injectables. The average reduction in patients taking sitagliptin ranged from 0.0% to 1.1%. The average reduction with sulfonylureas ranged from 0.4% to 1.4%, and the average reduction with thiazolidinediones ranged from 0.4% to 0.8%.

Among 348 patients in the liraglutide group with baseline HbA_1c levels of 7.5% or less, 216 (63%) reached the AACE-recommended HbA_1c target of 6.5% or less, compared with less than half (20%-49%) of patients with a baseline HbA_1c of 7.5% or less in the other groups, Dr. Henry noted.

Among 333 patients in the liraglutide group with HbA_1c levels greater than 9.0%, 33 (10%) reached the 6.5% or less target, compared with 4 (12%) of 34 patients in the insulin glargine group and 0%-5% of patients in the other groups.

The study was limited by the use of mean data, which does not account for individual variability, but the results suggest that liraglutide was effective at reducing HbA_1c throughout the baseline HbA_1c spectrum, Dr. Henry said.

The study was sponsored by Novo Nordisk, which manufactures liraglutide. Dr. Henry has received research support from multiple pharmaceutical companies, including Amylin Pharmaceuticals, AstraZeneca, and Novartis. He has served as an adviser or consultant for, and has received consulting fees from, several companies, including Amylin, Eli Lilly, and Novo Nordisk.

SAN DIEGO – Type 2 diabetes patients achieved greater blood sugar control with once-daily liraglutide injections than with other standard type 2 diabetes medications, according to the findings from a meta-analysis of seven phase III studies. The findings were presented April 14 at the annual meeting of the American Association of Clinical Endocrinologists.

"The progressive nature of type 2 diabetes makes it difficult for any single therapy to be effective long-term," said Dr. Robert Henry of the University of California, San Diego.

Liraglutide (Victoza) was approved by the Food and Drug Administration in January 2010 to treat type 2 diabetes in adults as an adjunct therapy to a healthy diet and exercise.

To further evaluate the impact of liraglutide on blood sugar control, Dr. Henry and his colleagues consolidated data from seven phase III clinical trials and divided the patients into five categories based on their baseline hemoglobin A_1c level: 7.5% or less (651 patients), 7.6%-8.0% (601 patients), 8.1%-8.5% (538 patients), 8.6%-9.0% (432 patients), and greater than 9.0% (607 patients).

The researchers reviewed the mean changes in HbA_1c from baseline to 26 weeks of treatment. Overall, mean hemoglobin A_1c reductions with a once-daily, 1.8-mg dose of liraglutide were greater than the reductions achieved with standard regimens involving exenatide, insulin glargine, glimepiride, rosiglitazone, or sitagliptin.

In particular, HbA_1c levels were significantly reduced in patients with a baseline HbA_1c of 7.5% or less in the liraglutide group compared with all other groups. The mean reductions in HbA_1c for patients on liraglutide ranged from 0.7% in the 7.5% or less category to 1.8% in the greater than 9.0% category. The next best mean reduction in HbA_1c was seen among patients taking two other injectable therapies: insulin glargine and exenatide. Reductions in HbA_1c in patients taking insulin glargine ranged from 0.3% to 1.5%, and HbA_1c reductions in those taking exenatide ranged from 0.4% to 1.3%.

Patients taking sulfonylureas, sitagliptin, or thiazolidinediones showed less improvement from baseline than did patients taking the injectables. The average reduction in patients taking sitagliptin ranged from 0.0% to 1.1%. The average reduction with sulfonylureas ranged from 0.4% to 1.4%, and the average reduction with thiazolidinediones ranged from 0.4% to 0.8%.

Among 348 patients in the liraglutide group with baseline HbA_1c levels of 7.5% or less, 216 (63%) reached the AACE-recommended HbA_1c target of 6.5% or less, compared with less than half (20%-49%) of patients with a baseline HbA_1c of 7.5% or less in the other groups, Dr. Henry noted.

Among 333 patients in the liraglutide group with HbA_1c levels greater than 9.0%, 33 (10%) reached the 6.5% or less target, compared with 4 (12%) of 34 patients in the insulin glargine group and 0%-5% of patients in the other groups.

The study was limited by the use of mean data, which does not account for individual variability, but the results suggest that liraglutide was effective at reducing HbA_1c throughout the baseline HbA_1c spectrum, Dr. Henry said.

The study was sponsored by Novo Nordisk, which manufactures liraglutide. Dr. Henry has received research support from multiple pharmaceutical companies, including Amylin Pharmaceuticals, AstraZeneca, and Novartis. He has served as an adviser or consultant for, and has received consulting fees from, several companies, including Amylin, Eli Lilly, and Novo Nordisk.

SAN DIEGO – Type 2 diabetes patients achieved greater blood sugar control with once-daily liraglutide injections than with other standard type 2 diabetes medications, according to the findings from a meta-analysis of seven phase III studies. The findings were presented April 14 at the annual meeting of the American Association of Clinical Endocrinologists.

"The progressive nature of type 2 diabetes makes it difficult for any single therapy to be effective long-term," said Dr. Robert Henry of the University of California, San Diego.

Liraglutide (Victoza) was approved by the Food and Drug Administration in January 2010 to treat type 2 diabetes in adults as an adjunct therapy to a healthy diet and exercise.

To further evaluate the impact of liraglutide on blood sugar control, Dr. Henry and his colleagues consolidated data from seven phase III clinical trials and divided the patients into five categories based on their baseline hemoglobin A_1c level: 7.5% or less (651 patients), 7.6%-8.0% (601 patients), 8.1%-8.5% (538 patients), 8.6%-9.0% (432 patients), and greater than 9.0% (607 patients).

The researchers reviewed the mean changes in HbA_1c from baseline to 26 weeks of treatment. Overall, mean hemoglobin A_1c reductions with a once-daily, 1.8-mg dose of liraglutide were greater than the reductions achieved with standard regimens involving exenatide, insulin glargine, glimepiride, rosiglitazone, or sitagliptin.

In particular, HbA_1c levels were significantly reduced in patients with a baseline HbA_1c of 7.5% or less in the liraglutide group compared with all other groups. The mean reductions in HbA_1c for patients on liraglutide ranged from 0.7% in the 7.5% or less category to 1.8% in the greater than 9.0% category. The next best mean reduction in HbA_1c was seen among patients taking two other injectable therapies: insulin glargine and exenatide. Reductions in HbA_1c in patients taking insulin glargine ranged from 0.3% to 1.5%, and HbA_1c reductions in those taking exenatide ranged from 0.4% to 1.3%.

Patients taking sulfonylureas, sitagliptin, or thiazolidinediones showed less improvement from baseline than did patients taking the injectables. The average reduction in patients taking sitagliptin ranged from 0.0% to 1.1%. The average reduction with sulfonylureas ranged from 0.4% to 1.4%, and the average reduction with thiazolidinediones ranged from 0.4% to 0.8%.

Among 348 patients in the liraglutide group with baseline HbA_1c levels of 7.5% or less, 216 (63%) reached the AACE-recommended HbA_1c target of 6.5% or less, compared with less than half (20%-49%) of patients with a baseline HbA_1c of 7.5% or less in the other groups, Dr. Henry noted.

Among 333 patients in the liraglutide group with HbA_1c levels greater than 9.0%, 33 (10%) reached the 6.5% or less target, compared with 4 (12%) of 34 patients in the insulin glargine group and 0%-5% of patients in the other groups.

The study was limited by the use of mean data, which does not account for individual variability, but the results suggest that liraglutide was effective at reducing HbA_1c throughout the baseline HbA_1c spectrum, Dr. Henry said.

The study was sponsored by Novo Nordisk, which manufactures liraglutide. Dr. Henry has received research support from multiple pharmaceutical companies, including Amylin Pharmaceuticals, AstraZeneca, and Novartis. He has served as an adviser or consultant for, and has received consulting fees from, several companies, including Amylin, Eli Lilly, and Novo Nordisk.

SAN DIEGO – Type 2 diabetes patients achieved greater blood sugar control with once-daily liraglutide injections than with other standard type 2 diabetes medications, according to the findings from a meta-analysis of seven phase III studies. The findings were presented April 14 at the annual meeting of the American Association of Clinical Endocrinologists.

"The progressive nature of type 2 diabetes makes it difficult for any single therapy to be effective long-term," said Dr. Robert Henry of the University of California, San Diego.

Liraglutide (Victoza) was approved by the Food and Drug Administration in January 2010 to treat type 2 diabetes in adults as an adjunct therapy to a healthy diet and exercise.

To further evaluate the impact of liraglutide on blood sugar control, Dr. Henry and his colleagues consolidated data from seven phase III clinical trials and divided the patients into five categories based on their baseline hemoglobin A_1c level: 7.5% or less (651 patients), 7.6%-8.0% (601 patients), 8.1%-8.5% (538 patients), 8.6%-9.0% (432 patients), and greater than 9.0% (607 patients).

The researchers reviewed the mean changes in HbA_1c from baseline to 26 weeks of treatment. Overall, mean hemoglobin A_1c reductions with a once-daily, 1.8-mg dose of liraglutide were greater than the reductions achieved with standard regimens involving exenatide, insulin glargine, glimepiride, rosiglitazone, or sitagliptin.

In particular, HbA_1c levels were significantly reduced in patients with a baseline HbA_1c of 7.5% or less in the liraglutide group compared with all other groups. The mean reductions in HbA_1c for patients on liraglutide ranged from 0.7% in the 7.5% or less category to 1.8% in the greater than 9.0% category. The next best mean reduction in HbA_1c was seen among patients taking two other injectable therapies: insulin glargine and exenatide. Reductions in HbA_1c in patients taking insulin glargine ranged from 0.3% to 1.5%, and HbA_1c reductions in those taking exenatide ranged from 0.4% to 1.3%.

Patients taking sulfonylureas, sitagliptin, or thiazolidinediones showed less improvement from baseline than did patients taking the injectables. The average reduction in patients taking sitagliptin ranged from 0.0% to 1.1%. The average reduction with sulfonylureas ranged from 0.4% to 1.4%, and the average reduction with thiazolidinediones ranged from 0.4% to 0.8%.

Among 348 patients in the liraglutide group with baseline HbA_1c levels of 7.5% or less, 216 (63%) reached the AACE-recommended HbA_1c target of 6.5% or less, compared with less than half (20%-49%) of patients with a baseline HbA_1c of 7.5% or less in the other groups, Dr. Henry noted.

Among 333 patients in the liraglutide group with HbA_1c levels greater than 9.0%, 33 (10%) reached the 6.5% or less target, compared with 4 (12%) of 34 patients in the insulin glargine group and 0%-5% of patients in the other groups.

The study was limited by the use of mean data, which does not account for individual variability, but the results suggest that liraglutide was effective at reducing HbA_1c throughout the baseline HbA_1c spectrum, Dr. Henry said.

The study was sponsored by Novo Nordisk, which manufactures liraglutide. Dr. Henry has received research support from multiple pharmaceutical companies, including Amylin Pharmaceuticals, AstraZeneca, and Novartis. He has served as an adviser or consultant for, and has received consulting fees from, several companies, including Amylin, Eli Lilly, and Novo Nordisk.

SAN DIEGO – Type 2 diabetes patients achieved greater blood sugar control with once-daily liraglutide injections than with other standard type 2 diabetes medications, according to the findings from a meta-analysis of seven phase III studies. The findings were presented April 14 at the annual meeting of the American Association of Clinical Endocrinologists.

"The progressive nature of type 2 diabetes makes it difficult for any single therapy to be effective long-term," said Dr. Robert Henry of the University of California, San Diego.

Liraglutide (Victoza) was approved by the Food and Drug Administration in January 2010 to treat type 2 diabetes in adults as an adjunct therapy to a healthy diet and exercise.

To further evaluate the impact of liraglutide on blood sugar control, Dr. Henry and his colleagues consolidated data from seven phase III clinical trials and divided the patients into five categories based on their baseline hemoglobin A_1c level: 7.5% or less (651 patients), 7.6%-8.0% (601 patients), 8.1%-8.5% (538 patients), 8.6%-9.0% (432 patients), and greater than 9.0% (607 patients).

The researchers reviewed the mean changes in HbA_1c from baseline to 26 weeks of treatment. Overall, mean hemoglobin A_1c reductions with a once-daily, 1.8-mg dose of liraglutide were greater than the reductions achieved with standard regimens involving exenatide, insulin glargine, glimepiride, rosiglitazone, or sitagliptin.

In particular, HbA_1c levels were significantly reduced in patients with a baseline HbA_1c of 7.5% or less in the liraglutide group compared with all other groups. The mean reductions in HbA_1c for patients on liraglutide ranged from 0.7% in the 7.5% or less category to 1.8% in the greater than 9.0% category. The next best mean reduction in HbA_1c was seen among patients taking two other injectable therapies: insulin glargine and exenatide. Reductions in HbA_1c in patients taking insulin glargine ranged from 0.3% to 1.5%, and HbA_1c reductions in those taking exenatide ranged from 0.4% to 1.3%.

Patients taking sulfonylureas, sitagliptin, or thiazolidinediones showed less improvement from baseline than did patients taking the injectables. The average reduction in patients taking sitagliptin ranged from 0.0% to 1.1%. The average reduction with sulfonylureas ranged from 0.4% to 1.4%, and the average reduction with thiazolidinediones ranged from 0.4% to 0.8%.

Among 348 patients in the liraglutide group with baseline HbA_1c levels of 7.5% or less, 216 (63%) reached the AACE-recommended HbA_1c target of 6.5% or less, compared with less than half (20%-49%) of patients with a baseline HbA_1c of 7.5% or less in the other groups, Dr. Henry noted.

Among 333 patients in the liraglutide group with HbA_1c levels greater than 9.0%, 33 (10%) reached the 6.5% or less target, compared with 4 (12%) of 34 patients in the insulin glargine group and 0%-5% of patients in the other groups.

The study was limited by the use of mean data, which does not account for individual variability, but the results suggest that liraglutide was effective at reducing HbA_1c throughout the baseline HbA_1c spectrum, Dr. Henry said.

The study was sponsored by Novo Nordisk, which manufactures liraglutide. Dr. Henry has received research support from multiple pharmaceutical companies, including Amylin Pharmaceuticals, AstraZeneca, and Novartis. He has served as an adviser or consultant for, and has received consulting fees from, several companies, including Amylin, Eli Lilly, and Novo Nordisk.

SAN DIEGO – Type 2 diabetes patients achieved greater blood sugar control with once-daily liraglutide injections than with other standard type 2 diabetes medications, according to the findings from a meta-analysis of seven phase III studies. The findings were presented April 14 at the annual meeting of the American Association of Clinical Endocrinologists.

"The progressive nature of type 2 diabetes makes it difficult for any single therapy to be effective long-term," said Dr. Robert Henry of the University of California, San Diego.

Liraglutide (Victoza) was approved by the Food and Drug Administration in January 2010 to treat type 2 diabetes in adults as an adjunct therapy to a healthy diet and exercise.

To further evaluate the impact of liraglutide on blood sugar control, Dr. Henry and his colleagues consolidated data from seven phase III clinical trials and divided the patients into five categories based on their baseline hemoglobin A_1c level: 7.5% or less (651 patients), 7.6%-8.0% (601 patients), 8.1%-8.5% (538 patients), 8.6%-9.0% (432 patients), and greater than 9.0% (607 patients).

The researchers reviewed the mean changes in HbA_1c from baseline to 26 weeks of treatment. Overall, mean hemoglobin A_1c reductions with a once-daily, 1.8-mg dose of liraglutide were greater than the reductions achieved with standard regimens involving exenatide, insulin glargine, glimepiride, rosiglitazone, or sitagliptin.

In particular, HbA_1c levels were significantly reduced in patients with a baseline HbA_1c of 7.5% or less in the liraglutide group compared with all other groups. The mean reductions in HbA_1c for patients on liraglutide ranged from 0.7% in the 7.5% or less category to 1.8% in the greater than 9.0% category. The next best mean reduction in HbA_1c was seen among patients taking two other injectable therapies: insulin glargine and exenatide. Reductions in HbA_1c in patients taking insulin glargine ranged from 0.3% to 1.5%, and HbA_1c reductions in those taking exenatide ranged from 0.4% to 1.3%.

Patients taking sulfonylureas, sitagliptin, or thiazolidinediones showed less improvement from baseline than did patients taking the injectables. The average reduction in patients taking sitagliptin ranged from 0.0% to 1.1%. The average reduction with sulfonylureas ranged from 0.4% to 1.4%, and the average reduction with thiazolidinediones ranged from 0.4% to 0.8%.

Among 348 patients in the liraglutide group with baseline HbA_1c levels of 7.5% or less, 216 (63%) reached the AACE-recommended HbA_1c target of 6.5% or less, compared with less than half (20%-49%) of patients with a baseline HbA_1c of 7.5% or less in the other groups, Dr. Henry noted.

Among 333 patients in the liraglutide group with HbA_1c levels greater than 9.0%, 33 (10%) reached the 6.5% or less target, compared with 4 (12%) of 34 patients in the insulin glargine group and 0%-5% of patients in the other groups.

The study was limited by the use of mean data, which does not account for individual variability, but the results suggest that liraglutide was effective at reducing HbA_1c throughout the baseline HbA_1c spectrum, Dr. Henry said.

The study was sponsored by Novo Nordisk, which manufactures liraglutide. Dr. Henry has received research support from multiple pharmaceutical companies, including Amylin Pharmaceuticals, AstraZeneca, and Novartis. He has served as an adviser or consultant for, and has received consulting fees from, several companies, including Amylin, Eli Lilly, and Novo Nordisk.

SAN DIEGO – Type 2 diabetes patients achieved greater blood sugar control with once-daily liraglutide injections than with other standard type 2 diabetes medications, according to the findings from a meta-analysis of seven phase III studies. The findings were presented April 14 at the annual meeting of the American Association of Clinical Endocrinologists.

"The progressive nature of type 2 diabetes makes it difficult for any single therapy to be effective long-term," said Dr. Robert Henry of the University of California, San Diego.

Liraglutide (Victoza) was approved by the Food and Drug Administration in January 2010 to treat type 2 diabetes in adults as an adjunct therapy to a healthy diet and exercise.

To further evaluate the impact of liraglutide on blood sugar control, Dr. Henry and his colleagues consolidated data from seven phase III clinical trials and divided the patients into five categories based on their baseline hemoglobin A_1c level: 7.5% or less (651 patients), 7.6%-8.0% (601 patients), 8.1%-8.5% (538 patients), 8.6%-9.0% (432 patients), and greater than 9.0% (607 patients).

The researchers reviewed the mean changes in HbA_1c from baseline to 26 weeks of treatment. Overall, mean hemoglobin A_1c reductions with a once-daily, 1.8-mg dose of liraglutide were greater than the reductions achieved with standard regimens involving exenatide, insulin glargine, glimepiride, rosiglitazone, or sitagliptin.

In particular, HbA_1c levels were significantly reduced in patients with a baseline HbA_1c of 7.5% or less in the liraglutide group compared with all other groups. The mean reductions in HbA_1c for patients on liraglutide ranged from 0.7% in the 7.5% or less category to 1.8% in the greater than 9.0% category. The next best mean reduction in HbA_1c was seen among patients taking two other injectable therapies: insulin glargine and exenatide. Reductions in HbA_1c in patients taking insulin glargine ranged from 0.3% to 1.5%, and HbA_1c reductions in those taking exenatide ranged from 0.4% to 1.3%.

Patients taking sulfonylureas, sitagliptin, or thiazolidinediones showed less improvement from baseline than did patients taking the injectables. The average reduction in patients taking sitagliptin ranged from 0.0% to 1.1%. The average reduction with sulfonylureas ranged from 0.4% to 1.4%, and the average reduction with thiazolidinediones ranged from 0.4% to 0.8%.

Among 348 patients in the liraglutide group with baseline HbA_1c levels of 7.5% or less, 216 (63%) reached the AACE-recommended HbA_1c target of 6.5% or less, compared with less than half (20%-49%) of patients with a baseline HbA_1c of 7.5% or less in the other groups, Dr. Henry noted.

Among 333 patients in the liraglutide group with HbA_1c levels greater than 9.0%, 33 (10%) reached the 6.5% or less target, compared with 4 (12%) of 34 patients in the insulin glargine group and 0%-5% of patients in the other groups.

The study was limited by the use of mean data, which does not account for individual variability, but the results suggest that liraglutide was effective at reducing HbA_1c throughout the baseline HbA_1c spectrum, Dr. Henry said.

The study was sponsored by Novo Nordisk, which manufactures liraglutide. Dr. Henry has received research support from multiple pharmaceutical companies, including Amylin Pharmaceuticals, AstraZeneca, and Novartis. He has served as an adviser or consultant for, and has received consulting fees from, several companies, including Amylin, Eli Lilly, and Novo Nordisk.