Victosa: the experience with clinical application in patients with type 2 diabetes mellitus
https://doi.org/10.14341/probl201157337-41
Abstract
Type 2 diabetes mellitus that comes from insulin resistance and deficit of insulin secretion has recently been described as associated with reduced incretin effect. The efficiency of traditional hypoglycemic therapy (metformin, secretagogues, glitazones, insulin) gradually decreases due to progressive loss of functioning beta-cell mass. The achievement of target blood glucose levels for the prevention of complications and cardiovascular pathology as a rule leads to such adverse events as increased body weight and hypoglycemia. The search for an «ideal» drug included the study and the use of incretin effect in DM2 patients. Liralglutide, the first analog of human glucagon-like peptide (GPP-1), is an innovative preparation with the desired properties the action of which is not confined to traditional hypoglycemic effects and improvement of glycemic control (as many as 65% of the patients have the targeted HbA1c level <7% at a minimal risk of hypoglycemia). It also prevents a rise in body weight, decreases arterial pressure and trigyceride levels, improves beta-cell function. This paper reports the first experience with clinical application of liraglutide (marketed in this country under commercial name Victosa since November 2010) for the treatment of patients with type 2 diabetes mellitus. Our data confirm results of the randomized placebo-controlled clinical study LEAD 1-6.
References
1. Turner R.C. et al. The UK Prospective Diabetes Study Group: glycemic control with diet, sulfonylurea, metformin or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). JAMA 1999;281:2005-2012.
2. Carver C. Insulin treatment and the problem of weight gain in type 2 diabetes. Diabet Educ 2006;32:910-917.
3. Anderson J.W., Kendall C.W. et al. Importance of weight management in type 2 diabetes: review with meta-analysis of clinical studies. J Am Coll Nuts 2003;22:331-339.
4. The Accord study group: Effect of intensive glucose lowering of type 2 diabetes. N Engl J Med 2008;358:2445-2559.
5. Abraria C. et al. Glycaemic separation and risk factor control in the VADT. Diabet Obes Metab 2008.
6. Holst J. The physiology and pharmacology of incretins in the type 2 diabetes. Diabetes Оbes Metab 2008;10:Suppl 3:14-21.
7. Garber A. Glucagon-like peptide - based therapies: new developments and emerging datа. Diabet Obes Metab 2008;10:Suppl 3:22-35.
8. Nauck M., Stockmann F. et al. Reduced incretin effect in type 2 (non-insulin-dependent) diabetes. Diabetologia 1986;29:46-52.
9. Tof-Nielsen M.B. et al. Determinants of the impaired secretion of glucagon-like peptide-1 in type 2 diabetic patients. J Clin Endocrinol Metab 2001;86:3717-3723.
10. Nauck M.A., Klein N. et al. Normalization of fasting hyperglycaemia by exogenous glucagon-like-peptide 1 (7-36 amide) in type 2 (non-insulin-dependent) diabetic patients. Diabetologia 1993;36:741-744.
11. Mayo K.E., Miller J.L. et al. The glucagon receptor family. Pharmacol Rev 2003;55:167-194.
12. Degn K.B., Juhl C.B. et al. One week`s treatment with long acting GLP 1 derivative liraglutide markedly improves 24-h glycemia and alfa and bête cell function and reduce endogenous glucose release in patients with type 2. Diabetes 2004;53:1187-1194.
13. Nauck M. et al. LEAD 1-5. Diabetes 2008;57:Suppl 1:A-150, A4.
14. Vilsboll T., Zdravcovich M. et al. Liraglutide, a long acting human GLP-1 analog, given as monotherapy significantly improves glycemic control and lowers body weight without risk of hypoglycaemia in patients with type 2 diabetes mellitus. Diabetes Care 2007;30:1608-1610.
15. Holst J.J., Nauck M. et al. Imhrovement in glycaemic control when adding Liraglutide to existing therapy results from a meta analysis of six large randomized clinical trails.
16. Vilsboll T. Liraglutidе: a once-dailly GLP-1 analogue for treatment of type 2 diabetes mellitus. Exp Opin Invest Drugs 2007;16:231-237.
17. Jendle J., Nauck M. et al. Liraglutidе Decreases the Body Fat Content and Hepatic Steatosis in Comparing with Glimeperide in Add on therapy with Metformin in type 2 Diabetic Patients. ADA 2008;Abstracts.
18. Mari A., Degn K. et al. Characterisation of beta-cell function improvement by Liraglutidе: modeling analysis of 24-h tests. Diabetes 2006;55:Suppl 1:A124.
19. Vilsboll T., Brock B. et al. Liraglutidе, a once-daily human analogue improves beta-cell function and arginine stimulated insulin secretion at hyperglycaemia in patients with type 2 diabetes. Diabet Med 2008;25:152-156.
20. Meier J.J., Kemmeries G. et al. Erythromycin antagonizes the dece leration of gastric emptying by glucagon-like peptide 1 and unmasks its insulinotropiceffect in healthy subjects. Diabetes 2005;54:2212-2218.
21. Nauck M.A., Niedereichholz U. et al. Glucagon-like peptide-1 inhibition of gastric emptying out weight its insulinotropic effects in healthy volunteers. Am J Physiol 1997;223:Е 981-Е 988.
22. Colagiuri S., Frid A. Once-daily Human GLP-1 analogue liraglutidе reduces systolic blood pressure in patients with type 2 diabetes. Diabetes 2008;57:Supple 1:544:A-164.
23. Vilsboll T., Zdravkovic M. et al. Liraglutidе treatment, blood pressure and biomarkers of cardiovascular risk in patients with type 2 diabetes;14 weeks monotherapy study. Diabetes 2006;55:Suppl 1:Abstract 2007-PO.
24. Courreges J.P., Vilsboll T. et al. Beneficial effects of once–daily liraglutide, a human glucagone-like peptide-1 analogue, on cardiovascular risk biomarkers in patients with type 2 diabetes. 25:Issue 9:1129-1131.
25. Bose A.K., Mocanu M.M. et al. Glucagone like peptide-1 can directly protect the heart against ischemia/reperfusion injury. Diabetes 2005;54:146-151.
Review
For citations:
Voĭchik É.A. Victosa: the experience with clinical application in patients with type 2 diabetes mellitus. Problems of Endocrinology. 2011;57(3):37-41. (In Russ.) https://doi.org/10.14341/probl201157337-41
Views:
539
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
Email this article 
.jpg){kind=logo}
