The Highlights of the AWARD Clinical Program FRANCESCO GIORGINO
|
|
- Damian Ward
- 5 years ago
- Views:
Transcription
1 The Highlights of the AWARD Clinical Program FRANCESCO GIORGINO DEPARTMENT OF EMERGENCY AND ORGAN TRANSPLANTATION SECTION OF INTERNAL MEDICINE, ENDOCRINOLOGY, ANDROLOGY AND METABOLIC DISEASES
2 Disclaimer This material is only for use by participants during the DEF meeting in Gdynia on 2 3 June 2017 Any potential use of this material outside of this meeting must be approved in accordance with local legal and compliance requirements This presentation reflects the external speaker's point of view and not necessarily those of the meeting sponsor (Eli Lilly and Company) 2
3 Disclosures Advisory Boards: AstraZeneca/BMS; Eli Lilly; Roche Diagnostics; Takeda Consultant: AstraZeneca/BMS; Boehringer Ingelheim; Lifescan; Merck Sharp & Dohme; Novo Nordisk; Sanofi Research Support: AstraZeneca/BMS; Eli Lilly; Lifescan; Sanofi; Takeda 3
4 Antihyperglycaemic Therapy in Type 2 Diabetes: ADA General Recommendations ADA, American Diabetes Association, DPP-4-i, dipeptidyl peptidase-4 inhibitor; GLP-1-RA, glucagon-like peptide-1 receptor agonist; SU, sulphonylurea; TZD, thiazolidinedione Diabetes Care 2017
5 Dulaglutide Clinical Trial Programme: AWARD More than 5000 patients have been enrolled in phase 3 clinical trials 1 The AWARD programme is robust and spans the continuum of care Monotherapy 2-drug combinations 3-drug combinations More complex insulin strategies AWARD-3 2 vs metformin Drug-naïve or washout from 1 oral antidiabetic medication AWARD-5 3 vs sitagliptin Add-on to metformin AWARD-6 4 vs liraglutide Add-on to metformin AWARD-1 5 vs exenatide BID Add-on to metformin and TZD AWARD-2 6 vs glargine Add-on to metformin and SU AWARD-4 7 vs glargine Both with mealtime insulin lispro With or without metformin AWARD = Assessment of Weekly AdministRation of LY in Diabetes. 1. Trulicity (dulaglutide injection) [summary of product characteristics]. Houten, The Netherlands: Eli Lilly and Company; Umpierrez G, et al. Diabetes Care. 2014;37(8): Nauck M, et al. Diabetes Care. 2014;37(8): Dungan KM, et al. Lancet (9951): Wysham C, et al. Diabetes Care. 2014;37(8): Giorgino F, et al Dec;38(12): , Jendle J, et al. Poster presented at: American Diabetes Association s 74th Scientific Sessions; June San Francisco, CA, USA.
6 Dulaglutide: AWARD 1 6 Key Results Trial AWARD-1 (combination with met + pio) AWARD-2 (combination with met + SU) AWARD-3 (monotherapy) AWARD-4 (combination with Insulin lispro +/- met) AWARD-5 (combination with met) Patient Number Primary Endpoint Final Endpoint Active Comparator Change in HbA 1c at Primary Endpoint 0.75mg 1.5mg Exenatide BID Superior Superior Glargine Non-inferior Superior Metformin Superior Superior Glargine + lispro Superior Superior Sitagliptin Superior Superior AWARD-6 (combination with met) Liraglutide 1.8 mg n.a. Non-inferior Wysham C et al. Diabetes Care 2014;37: ; Giorgino F et al. Diabetes Care 2015 Dec;38(12):2241-9; Umpierrez G et al. Diabetes Care 2014;37(8): ; Blonde L, et al., Lancet. 2015; 385(9982): ; Nauck MA et al. Diabetes Care 2014;37: ; Dungan KM et al. Lancet 2014 July 11, doi: /s (14)
7 HbA1c, Change from Baseline (%, LS Mean) Dulaglutide 1.5 mg Demonstrated Significant HbA 1c Reduction vs Established Glucose-lowering Agents Baseline HbA1c (%) N= 0 AWARD-5 1 AWARD-1 2 AWARD-2 Add-on to metformin Add-on to metformin 3 Add-on to metformin and pioglitazone and SU % (-12.0) P< % (-4.3) vs sitagliptin (52 weeks) % (-16.5) P< % (-10.8) -0.46% (-5.0) *P<.001 P<.001 vs exenatide BID (26 weeks) % (-11.8) -0.63% (-6.9) P<.001 vs insulin glargine (52 weeks) HbA1c, Change from Baseline (mmol/mol, LS Mean) Dulaglutide 1.5 mg Comparator Placebo Data presented are mean values at primary time points. Values in parentheses are mmol/mol. P-values represent superiority. *P<.001 vs placebo. The recommended dose for Trulicity is 1.5 mg when prescribed as add-on therapy. For monotherapy or for potentially vulnerable populations such as patients 75 years of age or patients with severe heart failure, 0.75 mg once weekly can be considered as a starting dose. 1. Nauck M, et al. Diabetes Care. 2014;37(8): Wysham C, et al. Diabetes Care. 2014;37(8): Giorgino F, et al Dec;38(12):
8 Plasma Exenatide (pg/ml) Dulaglutide concentration (ng/ml) Pharmacokinetics of Exenatide BID/OW and Dulaglutide Pharmacokinetics of short (twice-daily, BID) or long (once-weekly, OW) acting exenatide 1,2 Dulaglutide 1.5 mg once-weekly SC concentration time profile Exenatide BID Exenatide OW mg SC observed (mean, SE) Predicted (estimated mean plasma dulaglutide concentrations, 90% CI) Half-life ~ 5 days Peak plasma concentrations in 48 hours (range hours) Days Weeks Days BID, twice daily; CI, confidence interval; OW, once weekly; SC, subcutaneous; SE, standard error 1 Kim D, et al. Diabetes Care 2007;30: ; 2 Fineman M, et al. Clin Pharmacokinet 2011;50:65 74; 3 de la Peña A, et al. 50th EASD Annual Meeting, Vienna, Austria, September 2014 [PS 066 Novel therapies; P-857]
9 FSG change over time (mmol/l, LS Mean ±SE) Dulaglutide Works Quickly to Reduce FSG vs Exenatide BID (AWARD-1) * P<.001 vs exenatide BID P<.001 vs placebo Dulaglutide 1.5 mg N=279 Exenatide BID N= Placebo N= * * * * * Time (weeks) * Metformin + pioglitazone background Baseline FSG= mmol/l * The recommended dose for Trulicity is 1.5 mg when prescribed as add-on therapy. For monotherapy or for potentially vulnerable populations such as patients 75 years of age or patients with severe heart failure, 0.75 mg once weekly can be considered as a starting dose. FSG = fasting serum glucose. 1. Wysham C, et al. Diabetes Care. 2014;37(8):
10 Differentiation of GLP-1 RAs: Glycaemic Targets and Mechanisms of Action Compounds Parameters Short-acting (Prandial) GLP-1 receptor agonists Exenatide (twice daily) Lixisenatide (once daily) Long-acting GLP-1 receptor agonists Liraglutide (once daily) Albiglutide (once weekly) Dulaglutide (once weekly) Exenatide LAR (once weekly) Half-life 2 5 hours 12 hours several days Receptor activation Intermittent Continuous Effects Fasting glucose reduction Modest Strong Fasting insulin secretion No effect Stimulation Fasting glucagon secretion Mild reduction Strong reduction Postprandial glucose excursion Strong reduction Modest reduction Postprandial glucagon secretion Strong reduction Mild reduction (?) Postprandial insulin secretion Reduction Stimulation Gastric emptying Strong deceleration Mild deceleration HbA 1c reduction % % GLP-1 RA, glucagon-like peptide-1 receptor agonist; HbA 1c, glycated haemoglobin; LAR, long-acting release Meier JJ. Nat Rev Endocrinol 2012;8: ; Giorgino F, et al. Diabetes Metab Res Rev 2016;32:
11 HbA 1c, Change from Baseline (%, LS Mean) Average Reduction in Weight (kg, LS Mean ±SE) AWARD-1: Effects of Dulaglutide 1.5 mg and Exenatide BID on HbA 1c Reduction and Body Weight Baseline HbA 1c (%) N= % (-16.5) P< % (-10.8) *P<.001 P<.001 vs exenatide BID (26 weeks) AWARD-1 Add-on to metformin and pioglitazone (26 weeks) % (-5.0) -1.0 Dulaglutide 1.5 mg HbA 1c, Change from Baseline (mmol/mol, LS Mean) P< vs exenatide BID Dulaglutide 1.5 mg (n=279; baseline 96 kg) Exenatide BID (10 mcg BID) (n=276; baseline 97 kg) Comparator Placebo Data presented are mean values at primary time points. Values in parentheses are mmol/mol. P-values represent superiority. *P <.001 vs placebo. The recommended dose for dulaglutide is 1.5 mg when prescribed as add-on therapy BID, twice daily; HbA 1c, glycated haemoglobin; LS, least squares; SE, standard error Wysham C, et al. Diabetes Care. 2014;37(8):
12 AWARD-1: Effects of Dulaglutide vs. Exenatide BID on SMPG Data presented are least squares means ± standard error, mixed effect model repeat measurement. Solid lines are baseline; dashed lines are at 26 weeks BID, twice daily; DU, dulaglutide; EX, exenatide; PL, placebo; SMPG, self-monitored plasma glucose Wysham C, et al. Diabetes Care 2014;37(8):
13 HbA 1c Change from Baseline ±SE (%, LS Mean) AWARD-6: Dulaglutide 1.5 mg QW Vs. Liraglutide 1.8 mg QD Effects on HbA 1c Reduction HbA 1c Change from Baseline ±SE (%, LS Mean) Dulaglutide 1.5 mg (n=299; baseline HbA 1c : 8.1%) Liraglutide 1.8 mg (n=300; baseline HbA 1c : 8.1%) % (-16 mmol/mol) -1.36% (-15 mmol/mol) -16 P<.0001 Data presented are mean values at 26 weeks. The recommended dose for dulaglutide is 1.5 mg when prescribed as add-on therapy. For monotherapy or for potentially vulnerable populations such as patients 75 years of age or patients with severe heart failure, 0.75 mg once weekly can be considered as a starting dose. HbA 1c, glycated haemoglobin; LS, least squares; QD, once daily; QW, once weekly; SE, standard error Dungan KM, et al. Lancet 2014;384:
14 Average Reduction in Weight (kg, LS Mean ±SE) Most Dulaglutide 1.5 mg-treated Patients Experienced a Secondary Benefit of Weight Loss, Regardless of Concomitant Therapy AWARD-6 1 Add-on to metformin (26 weeks) P< AWARD-5 2 Add-on to metformin (52 weeks) P< AWARD-1 3 Add-on to metformin and pioglitazone (26 weeks) AWARD-2 4 Add-on to metformin and glimepiride (52 weeks) vs liraglutide vs sitagliptin vs exenatide BID vs insulin glargine Dulaglutide 1.5 mg (n=299; baseline 93.8 kg) Liraglutide 1.8 mg (n=300; baseline 94.4 kg) Dulaglutide 1.5 mg (n=304; baseline 87 kg) Sitagliptin (n=315; baseline 86 kg) Dulaglutide 1.5 mg (n=279; baseline 96 kg) Exenatide BID (10 mcg BID) (n=276; baseline 97 kg) Dulaglutide 1.5 mg (n=273) Insulin glargine (n=262; baseline weight across arms 86.3 kg) P<.474 P<.001 Trulicity is not indicated for weight loss; weight change was a secondary endpoint in clinical trials. The recommended dose for Trulicity is 1.5 mg when prescribed as add-on therapy. For monotherapy or for potentially vulnerable populations such as patients 75 years of age or patients with severe heart failure, 0.75 mg once weekly can be considered as a starting dose. 1. Dungan KM, et al. Lancet (9951): Nauck M, et al. Diabetes Care. 2014;37(8): Wysham C, et al. Diabetes Care. 2014;37(8): Giorgino F, et al. Diabetes Care Dec;38(12):
15 AWARD-2: Dulaglutide vs. Insulin Glargine in T2DM T2DM not optimally controlled on 1, 2 or 3 OAMs; HbA 1c 7.0% and 11% at screening; HbA 1c >6.5% at pre-randomisation visit Dulaglutide 1.5 mg Background Therapy a Dulaglutide 0.75 mg Insulin glargine titrated to target b Screening & Lead-in Treatment Period Safety Followup Followup Week Randomisation Primary Time Point Final Time Point a During the lead-in period, metformin ( 1,500 mg) and glimepiride ( 4 mg) were titrated up to maximum tolerated dose, then doses were stable for 6 8 weeks. OAMs continued for the duration of the trial. b Titrated to fasting plasma glucose target: <5.6 mmol/l according to Kennedy et al. 2006; GOAL HbA 1c Trial HbA 1c, glycated haemoglobin; OAM, oral anti-diabetes medication; T2DM, type 2 diabetes mellitus Giorgino F, et al. Diabetes Care 2015;38:
16 AWARD-2: Dulaglutide vs. Insulin Glargine in T2DM Baseline HbA 1c : 8.1% 8.2% Insulin Glargine QD Dulaglutide 0.75 mg OW Dulaglutide 1.5 mg OW Change in HbA 1c (%) Change in Body Weight (kg) Rates of Total Hypoglycaemia (event/patient/year) / ## 4.8 ## 23 # /18 # ## 5.2 # 29 # /39 ## Incidence of Diarrhoea/Nausea at 52 weeks (n) p <0.001 OW, superiority vs. glargine (1-sided, adjusted to control for type I error) p <0.001, noninferiority vs. glargine # p <0.05 vs. glargine ## p <0.001 vs. glargine HbA 1c, glycated haemoglobin; OW, once weekly; QD, once daily; T2DM, type 2 diabetes mellitus Giorgino F, et al. Diabetes Care 38:2241-9, 2015
17 Quality of Life in AWARD-2 Change from BL score, ITT, LOCF, LS mean (SE) DU 1.5 mg N= wks DU 0.75 mg N= wks Glargine N= wks EQ-5D VAS 3.17 (0.85)* 2.27 (0.85) # 1.06 (0.88) APPADL 0.9 (0.31)* # 0.4 (0.31) # -0.6 (0.32) IW-SP 0.5 (0.16)* 0.2 (0.16) 0.1 (0.16) LBSS, behaviour -2.1 (0.47)* # -2.1 (0.48)* # -0.8 (0.49) LBSS, worry -2.2 (0.50)* # -2.1 (0.50)* # -0.3 (0.52) *# 2-sided p<0.05 vs. BL and insulin glargine APPADL, Ability to Perform Physical Activities of Daily Living; BL, baseline; DU, dulaglutide; EQ-5D, EuroQoL-5 dimension; ITT, intention-to-treat population; IW-SP, Impact of Weight on Self-Perception; LBSS, low blood sugar survey; LOCF, last observation carried forward; LS, least squares; SE, standard error; VAS, visual analogue scale; wks, weeks Reaney M, et al. Patient-reported outcomes with once weekly dulaglutide 21 vs. insulin glargine (AWARD-2). ADA, 2014: abstract P-979
18 GLP-1 RA vs. Insulin: Change in HbA 1c Favours GLP-1 RA % Favours Insulin GLP-1 RA, glucagon-like peptide-1 receptor agonist; HbA 1c, glycated haemoglobin, OGLM, oral glucose lowering medication Abd El Aziz MS, et al. Diabetes Obes Metab 2017;19(2):
19 GLP-1 RA vs. Basal Insulin in T2DM: HbA 1c Reduction According to Baseline HbA 1c FPG, fasting plasma glucose; FSG, fasting serum glucose; GLP-1 RA, glucagon-like peptide-1 receptor agonist; HbA 1c, glycated haemoglobin OW, once weekly, T2DM, type 2 diabetes mellitus Buse JB, et al. Diabetes Obes Metab 2015;17:
20 DU, dulaglutide; HbA 1c, glycated haemoglobin Gallwitz B, et al. DOM 2017 Efficacy of Dulaglutide According to Gender, Duration of Diabetes, and Baseline HbA 1c (AWARD-1 to -6 and -8 clinical trials)
21 GLP-1 RA vs. Insulin: Change in Body Weight Favours GLP-1 RA kg Favours Insulin GLP-1 RA, glucagon-like peptide-1 receptor agonist; HbA 1c, glycated haemoglobin; OGLM, ordinal generalized linear model Abd El Aziz MS, et al. Diabetes Obes Metab 2017;19(2):
22 Insulin and GLP-1 RA in Type 2 diabetes Drug MoA/Effects Drug MoA/Effects Basal insulin Hepatic glucose production Reduction of FPG Body weight gain (+) Hypoglycaemia risk (+) GLP-1 RA long-acting Insulin secretion Glucagon secretion (fasting) Reduction of FPG > PPG Satiety and body weight loss Prandial insulin Skeletal muscle glucose disposal ( Hepatic glucose output) Reduction of PPG Body weight gain (++) Hypoglycaemia risk (++) GLP-1 RA short-acting then insulin secretion (postprandial) Glucagon secretion (post-prandial) Gastric emptying rates Reduction of PPG excursions Satiety and body weight loss Adapted from Inzucchi SE, et al. Diabetes Care 2012;35: ; Meier JJ. Nat Rev Endocrinol 2012;8:
23 AWARD-9: Study Design Key inclusion criteria Treatment with insulin glargine once daily (+/- metformin) for at least 3 months prior to study entry A1C 7.0% and 10.5% Required glargine dose increase at randomization per the treat-to-target algorithm Body mass index 45 kg/m 2 Key exclusion criteria Type 1 diabetes Treated with ANY other antihyperglycemia regimen egfr <30 ml/min/1.73 m 2 Dulaglutide 1.5 mg + Titrated Basal Insulin Glargine (+/- Metformin) Screening/ Lead-in a Placebo + Titrated Basal Insulin Glargine (+/- Metformin) Treatment Period Week Randomization 28 Primary/Final Time Point Stabilization Period Insulin Glargine Titration Period a Patients continued prestudy regimens; did not change antihyperglycemia medications used or their doses, except when allowed per protocol. Stabilization Period = Weeks 0 to 4 w/ restricted insulin dose adjustments. Glargine Titration Period = Weeks 4 to 28 w/ unrestricted insulin dose adjustments. Pozzilli P. et al., DOM 2017
24 AWARD-9: Change in A1C at 28 Weeks Data presented are LS mean ± SE *, # p<.001 vs baseline and placebo, respectively a Treatment difference (95% CI), ITT, MMRM analysis Pozzilli P. et al., DOM 2017
25 AWARD-9: Insulin Doses at 28 weeks Data presented are LS mean ± SE except baseline values are mean ± SE *, # p< vs baseline and placebo, respectively a Treatment difference (95% CI), ITT, MMRM analysis Pozzilli P. et al., DOM 2017
26 AWARD-9: Change in Body Weight at 28 Weeks Data presented are LS mean ± SE. *, # p<.001 vs baseline and placebo, respectively. a Treatment difference (95% CI), ITT, MMRM analysis Pozzilli P. et al., DOM 2017
27 AWARD-9: Overall Incidence and Rate of Hypoglycemia through 28 Weeks Variable Total Hypoglycemia Dulaglutide 1.5 mg N=150 Placebo N=150 Incidence, n (%) 82 (54.7) 76 (50.7) Mean (SD) Rate Adjusted for 1 Year 7.69 (15.15) 8.56 (16.13) Documented Symptomatic Hypoglycemia Incidence, n (%) 53 (35.3) 45 (30.0) Mean (SD) Rate Adjusted for 1 Year 3.38 (8.62) 4 38 (11.70) Nocturnal Hypoglycemia Incidence, n (%) 42 (28.0) 43 (28.7) Mean (SD) Rate Adjusted for 1 Year 2 76 (7.92) 3.03 (8.96) Severe Hypoglycemia Incidence, n (%) 1 (0.7) 0 (0.0) Mean (SD) Rate Adjusted for 1 Year 0.01 (0.15) 0 (0.0) ITT, Logistic regression using LOCF analysis, 70 mg/dl threshold Pozzilli P. et al., DOM 2017
28 Adverse Reactions Adverse Reaction Dulaglutide 1.5 mg Gastrointestinal (primary endpoint) a Nausea 7-28% Vomiting 3-17% Gastrointestinal events were mild or moderate, transient, and peaked during the first 2 weeks and rapidly declined over the next 4 weeks Hypoglycaemia, total Cardiovascular Systolic blood pressure Heart rate Atrioventricular block/ PR interval Injection-site reactions 1.9%* 1 event/patient/year (in trials without SU or insulin) Mean decrease 1-3 mmhg Mean increase 2-4 bpm Mean increase in PR interval 2-3 milliseconds 2.4% incidence of first-degree atrioventricular block a Gastrointestinal data from presentation 4, posters 919-P, 920-P, and 921-P, EASD, Barcelona, Spain, September 2013; Clinical Study Report, (GBDB_prd_SMTEAE11.RTF and GBDD_prd_SMTEAE14.RTF); and Integrated Safety Database * Pooled analysis across both doses.
29 Therapeutic Indications Trulicity is indicated in adults with type 2 diabetes mellitus to improve glycaemic control as: Add-on therapy In combination with other glucose-lowering medicinal products, including insulin, when these, together with diet and exercise, do not provide adequate glycaemic control. The recommended dose is 1.5 mg once weekly. For potentially vulnerable populations, such as patients 75 years, 0.75 mg once weekly can be considered as a starting dose. Monotherapy When diet and exercise alone do not provide adequate glycaemic control in patients for whom the use of metformin is considered inappropriate due to intolerance or contraindications. The recommended dose is 0.75 mg once weekly. Trulicity (dulaglutide injection) [draft summary of product characteristics]. Houten, The Netherlands: Eli Lilly and Company; 2014.
30 LEADER: Change in egfr during the Trial in Subgroups Stratified According to egfr at Baseline egfr >90 egfr egfr egfr <30 egfr, estimated GFR, ml/min/1.73m 2; Mann JFE, et al. N Engl J Med 2017;377:
31 AWARD-7: Study Design Screening a Dulaglutide 1.5 mg once weekly + prandial lispro Dulaglutide 0.75 mg once weekly + prandial lispro Insulin glargine + prandial lispro Safety Followup Lead In a Treatment Period Follow-up Visit: Group A 1 1A 2 3 b T 4 T 5 T 6 7 T 8 9 T T T T Group B 1 1A 2 Week: Group A b Group B -3 1A -1 Randomisation Primary Endpoint Final Endpoint AWARD-7 was a multicentre, parallel-arm, randomised, 52-week clinical trial that assessed the efficacy and safety of dulaglutide at two dose levels compared to insulin glargine in people with type 2 diabetes and moderate or severe chronic kidney disease Participants were randomised (1:1:1) to dulaglutide 1.5 mg (N=192) or dulaglutide 0.75 mg (N=190) or titrated insulin glargine (N=194) Key inclusion criteria: adults with T2D, egfr of <60 to 15 ml/min/1.73 m 2, BMI kg/m 2, HbA1c 7.5% and 10.5% for patients receiving insulin + OAM(s) and/or pramlintide or only insulin prior to screening a Group A: patients who were taking oral antihyperglycemic medication(s) ± pramlintide in addition to insulin at screening had a 13-week screening/lead-in period; Group B: patients who only take insulin at screening had a 3-week screening/lead-in period; b Once patients are randomised, there is no distinction between Groups A and B. Insulin glargine dose was adjusted to target fasting PG values between mg/dl ( mmol/l), and insulin lispro doses were adjusted to target pre-prandial PG values between mg/dl ( mmol/l). HbA1c, glycated haemoglobin; BMI, body mass index; egrf, estimated glomerular filtration rate; PG, plasma glucose; OAM, oral antidiabetic medication Tuttle KR, et al. Poster presented at the American Diabetes Association 77 th Scientific Sessions; San Diego, CA; June 9-13, 2017 [138-P]
32 Demographics AWARD-7: Baseline Characteristics DU 1.5 mg N=192 DU 0.75 mg N=190 Glargine N=194 Sex, women 88 (45.8) 86 (45.3) 101 (52.1) Age, years 64.7 ± ± ± 8.4 Duration of diabetes, years 17.6 ± ± ± 8.7 HbA1c, % 8.6 ± ± ± 1.0 FBG, mg/dl ± ± ± 72.2 Weight, kg 88.1 ± ± ± 18.5 BMI, kg/m ± ± ± 5.3 Daily total insulin dose, U 58.8 ± ± ± 34.2 egfr-epi-creatinine 1, ml/min/1.73m ± ± ± Baseline egfr <90 9 (4.7) 7 (3.7) 14 (7.2) 45 Baseline egfr <60 53 (27.6) 53 (27.9) 51 (26.3) 30 Baseline egfr <45 73 (38.0) 75 (39.5) 67 (34.5) 15 Baseline egfr <30 55 (28.6) 55 (28.9) 61 (31.4) Baseline egfr <15 2 (1.0) 0 (0.0) 1 (0.5) UACR, g/kg (mean [median]) (213.7) (233.6) (195.6) Microalbuminuria (30 UACR 300) 74 (38.5) 61 (32.3) 56 (28.9) Macroalbuminuria (UACR >300) 84 (43.8) 84 (44.4) 90 (46.4) Data presented as mean ± SD or n (%), unless otherwise noted, MMRM analysis. egfr was calculated based on the CKD-EPI equation 1. Abbreviations: A1c=glycated A1c; BMI=body mass index; DU=dulaglutide; FBG=fasting blood glucose.
33 HbA1c, Change from Baseline (%) AWARD-7: Key Results 0 26 Weeks 0-0,2-0,4-0,6-0,8-1 -1,2-1, ** ** ** (-0.26, 0.15),,a 0.02 (-0.18, 0.22),a HbA1c, Change from Baseline (mmol/mol) Dulaglutide 1.5 mg Dulaglutide 0.75 mg Insulin Glargine Data presented as LS mean (SE); mitt excluding post-rescue values and after study drug discontinuation, MMRM; **p<0.001 vs. BL,, p<0.001, non-inferiority vs. insulin glargine with a 0.4% margin or 0.3% margin; a Treatment difference [LSM difference (nominal 95% CI)]. BL, baseline; CI, confidence interval; LSM, least squares mean; mitt, modified intent-to-treat; MMRM, mixed-model repeated measures Tuttle KR, et al. Poster presented at the American Diabetes Association 77 th Scientific Sessions; San Diego, CA; June 9-13, 2017 [138-P]
34 AWARD-7: Key Results Tuttle KR, et al. Poster presented at the American Diabetes Association 77 th Scientific Sessions; San Diego, CA; June 9-13, 2017 [142-P]
35 AWARD-7: Change in UACR by Macroalbuminuria Data presented as LSM (95% CI); Safety population, MMRM analysis; *,**p<0.05 or p<0.001 vs. BL, # p<0.05 vs. insulin glargine. BL, baseline; CI, confidence interval; LSM, least squares mean; MMRM, mixed model repeated measures; UACR, urine albumin:creatinine ratio. Tuttle KR, et al. Poster presented at the American Diabetes Association 77 th Scientific Sessions; San Diego, CA; June 9-13, 2017 [142-P]
36 Evaluating Preferences for Profiles of GLP-1 Receptor Agonists among Injection-Naïve Type 2 Diabetes Patients in the UK Parameter Overall Part- Worth Utility Values 1 Relative Importance (%) 2 Dosing frequency Type of delivery system Frequency of nausea Weight change Blood sugar (HbA 1c ) change Rank Frequency of low blood sugar events (hypoglycaemia) When provided with a direct comparison, the vast majority of patients preferred the medication profile representing the characteristics of dulaglutide (83.1%) over the profile representing the characteristics of liraglutide (16.9%) 1 Overall utility values represent the range of utility values within each attribute 2 Relative importance for each attribute = overall utility value for each attribute/total utility value, where total utility value = sum of overall utility values across all attributes Gelhorn HL, et al. Patient Prefer Adherence 2015; 9:
37 Dulaglutide Pen Usability Outcomes In a usability study of injection-naïve patients, most patients were able to use the pen successfully and agreed or strongly agreed that dulaglutide ready-to-use single-dose pen was overall easy to use. 99% 99% 97% Final injection success rate Rated easy to use Willing to continue use Matfin G, et al. J Diabetes Sci Technol 2015; 9:
38 Probability of Persistence Kaplan-Meyer Persistence Curves for Dulaglutide and Liraglutide CI, confidence interval; HR, hazard ratio Alatorre C, et al. Diabetes Obes Metab Epub 9 Feb doi: /dom.12902
39 Probability of Persistence Kaplan-Meyer Persistence Curves for Dulaglutide and Exenatide QW CI, confidence interval; HR, hazard ratio; QW, once weekly Alatorre C, et al. Diabetes Obes Metab Epub 9 Feb doi: /dom.12902
40 Long-Acting GLP-1 Receptor Agonists Characteristics of Dulagutide Robust efficacy on HbA1c lowering (e.g., vs basal insulin or short-acting GLP-1 RA) Rapidity of action Low hypoglycaemia risk Weight reduction Improved adherence (once-weekly dosing, ease of administration) Potential for CV protection Potential for renal protection
41 Bari Seafront and Old Town Thank you!
Lilly Diabetes: Pipeline Update
Lilly Diabetes: Pipeline Update June 16, 2014 Safe Harbor Provision This presentation contains forward-looking statements that are based on management's current expectations, but actual results may differ
More informationEarly treatment for patients with Type 2 Diabetes
Israel Society of Internal Medicine Kibutz Hagoshrim, June 22, 2012 Early treatment for patients with Type 2 Diabetes Eduard Montanya Hospital Universitari Bellvitge-IDIBELL CIBERDEM University of Barcelona
More informationFrancesca Porcellati
XX Congresso Nazionale AMD Razionali e Benefici dell Aggiunta del GLP-1 RA Short-Acting all Insulina Basale Francesca Porcellati Dipartimento di Medicina Interna, Sezione di Medicina Interna, Endocrinologia
More informationGLP-1 agonists. Ian Gallen Consultant Community Diabetologist Royal Berkshire Hospital Reading UK
GLP-1 agonists Ian Gallen Consultant Community Diabetologist Royal Berkshire Hospital Reading UK What do GLP-1 agonists do? Physiology of postprandial glucose regulation Meal ❶ ❷ Insulin Rising plasma
More informationdulaglutide 0.75mg and 1.5mg solution for injection in pre-filled pen (Trulicity ) SMC No. (1110/15) Eli Lilly and Company Ltd.
dulaglutide 0.75mg and 1.5mg solution for injection in pre-filled pen (Trulicity ) SMC No. (1110/15) Eli Lilly and Company Ltd. 04 December 2015 The Scottish Medicines Consortium (SMC) has completed its
More informationAchieving and maintaining good glycemic control is an
Glycemic Efficacy, Weight Effects, and Safety of Once-Weekly Glucagon-Like Peptide-1 Receptor Agonists Yehuda Handelsman, MD, FACP, FNLA, FASPC, MACE; Kathleen Wyne, MD, PhD, FACE, FNLA; Anthony Cannon,
More informationexenatide 2mg powder and solvent for prolonged-release suspension for injection (Bydureon ) SMC No. (748/11) Eli Lilly and Company Limited
exenatide 2mg powder and solvent for prolonged-release suspension for injection (Bydureon ) SMC No. (748/11) Eli Lilly and Company Limited 09 December 2011 The Scottish Medicines Consortium (SMC) has completed
More informationSelecting GLP-1 RA Treatment
Selecting GLP-1 RA Treatment Dr Felicity Kaplan March 2017 Objectives Review the progressive nature of type 2 diabetes Understand the need for timely treatment intensification Examine the place of GLP-1
More informationThe first stop for professional medicines advice
London Medicines Evaluation Network Overview: Glucagon-Like Peptide-1 receptor analogues The first stop for professional medicines advice 1 London Medicines Evaluation Network Overview: Glucagon-Like Peptide-1
More informationDulaglutide: designed with patients in mind
31 st Panhellenic Annual Congress of the Hellenic Association for the Study & Education of Diabetes Mellitus Thessaloniki 11 th, November 2017 Dulaglutide: designed with patients in mind Imre Pavo MD PhD
More informationNew Drug Evaluation: Dulaglutide
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35, Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationADA Analyst Presentation Saturday 9 th June
ADA Analyst Presentation Saturday 9 th June Carlo Russo Senior Vice-President & Albiglutide Team Leader, GSK Property of GlaxoSmithKline Agenda Welcome & introduction to the Harmony Clinical Programme
More informationInsulin Initiation and Intensification. Disclosure. Objectives
Insulin Initiation and Intensification Neil Skolnik, M.D. Associate Director Family Medicine Residency Program Abington Memorial Hospital Professor of Family and Community Medicine Temple University School
More informationIncretin-based Therapies for Type 2 Diabetes Comparisons Between Glucagon-like Peptide-1 Receptor Agonists and Dipeptidyl Peptidase-4 Inhibitors
Incretin-based Therapies for Type 2 Diabetes Comparisons Between Glucagon-like Peptide-1 Receptor Agonists and Dipeptidyl Peptidase-4 Inhibitors Timothy Bailey, MD, FACE, CPI Director, AMCR Institute,
More informationSafety profile of Liraglutide: Recent Updates. Mohammadreza Rostamzadeh,M.D.
Safety profile of Liraglutide: Recent Updates Mohammadreza Rostamzadeh,M.D. Pancreatitis: Victoza post-marketing experience: spontaneous reports of pancreatitis For the majority of the cases, there is
More informationBasal & GLP-1 Fixed Combination Use
Basal & GLP-1 Fixed Combination Use Michelle M. Mangual, MD Diplomate of the American board of Internal Medicine and Endocrinology, Diabetes and Metabolism San Juan City hospital Learning Objectives o
More informationGLP 1 agonists Winning the Losing Battle. Dr Bernard SAMIA. KCS Congress: Impact through collaboration
GLP 1 agonists Winning the Losing Battle Dr Bernard SAMIA KCS Congress: Impact through collaboration CONTACT: Tel. +254 735 833 803 Email: kcardiacs@gmail.com Web: www.kenyacardiacs.org Disclosures I have
More informationScottish Medicines Consortium
Scottish Medicines Consortium liraglutide 6mg/mL prefilled pen for injection (3mL) (Victoza ) Novo Nordisk Ltd. No. (585/09) 06 November 2009 The Scottish Medicines Consortium (SMC) has completed its assessment
More informationGLP-1 (glucagon-like peptide-1) Agonists (Byetta, Bydureon, Tanzeum, Trulicity, Victoza ) Step Therapy and Quantity Limit Criteria Program Summary
OBJECTIVE The intent of the GLP-1 (glucagon-like peptide-1) s (Byetta/exenatide, Bydureon/ exenatide extended-release, Tanzeum/albiglutide, Trulicity/dulaglutide, and Victoza/liraglutide) Step Therapy
More informationAlbiglutide, a Once-Weekly GLP-1RA, for the Treatment of Type 2 Diabetes
St. Onge et al. Medical Research Archives, vol. 5, issue 11, November 2017 issue Page 1 of 10 REVIEW ARTICLE Albiglutide, a Once-Weekly GLP-1RA, for the Treatment of Type 2 Diabetes Erin St. Onge 1*, Shannon
More informationPractical Strategies for the Clinical Use of Incretin Mimetics CME/CE. CME/CE Released: 09/15/2009; Valid for credit through 09/15/2010
Practical Strategies for the Clinical Use of Incretin Mimetics CME/CE Robert R. Henry, MD Authors and Disclosures CME/CE Released: 09/15/2009; Valid for credit through 09/15/2010 Introduction Type 2 diabetes
More informationMOA: Long acting glucagon-like peptide 1 receptor agonist
Alexandria Rydz MOA: Long acting glucagon-like peptide 1 receptor agonist Increases glucose dependent insulin secretion Decreases inappropriate glucagon secretion Increases β- cell growth and replication
More informationTo assess the safety and tolerability in each treatment group.
These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert in the country of prescription. Sponsor: Sanofi Drug substance(s):
More informationGLP-1RA and insulin: friends or foes?
Tresiba Expert Panel Meeting 28/06/2014 GLP-1RA and insulin: friends or foes? Matteo Monami Careggi Teaching Hospital. Florence. Italy Dr Monami has received consultancy and/or speaking fees from: Merck
More informationDiabetes: Three Core Deficits
Diabetes: Three Core Deficits Fat Cell Dysfunction Impaired Incretin Function Impaired Appetite Suppression Obesity and Insulin Resistance in Muscle and Liver Hyperglycemia Impaired Insulin Secretion Islet
More informationNew Drug Evaluation: lixisenatide injection, subcutaneous
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationSoo LIM, MD, PHD Internal Medicine Seoul National University Bundang Hospital
Soo LIM, MD, PHD Internal Medicine Seoul National University Bundang Hospital Agenda Association between Cardiovascular Disease and Type 2 Diabetes Importance of HbA1c Management esp. High risk patients
More informationDulaglutide (LY ) for the treatment of type 2 diabetes
Expert Review of Clinical Pharmacology ISSN: 1751-2433 (Print) 1751-2441 (Online) Journal homepage: http://www.tandfonline.com/loi/ierj20 (LY-2189265) for the treatment of type 2 diabetes André J. Scheen
More informationIntensifying Treatment Beyond Monotherapy in T2DM: Where Do Newer Therapies Fit?
Intensifying Treatment Beyond Monotherapy in T2DM: Where Do Newer Therapies Fit? Vanita R. Aroda, MD Scientific Director & Physician Investigator MedStar Community Clinical Research Center MedStar Health
More informationOral Agents. Ian Gallen Consultant Community Diabetologist Royal Berkshire Hospital Reading UK
Oral Agents Ian Gallen Consultant Community Diabetologist Royal Berkshire Hospital Reading UK What would your ideal diabetes drug do? Effective in lowering HbA1c No hypoglycaemia No effect on weight/ weight
More informationSitagliptin: first DPP-4 inhibitor to treat type 2 diabetes Steve Chaplin MSc, MRPharmS and Andrew Krentz MD, FRCP
Sitagliptin: first DPP-4 inhibitor to treat type 2 diabetes Steve Chaplin MSc, MRPharmS and Andrew Krentz MD, FRCP KEY POINTS sitagliptin (Januvia) is a DPP-4 inhibitor that blocks the breakdown of the
More informationDM-2 Therapy Update: GLP-1, SGLT-2 Inhibitors, and Inhaled Insulin, Oh My!
DM-2 Therapy Update: GLP-1, SGLT-2 Inhibitors, and Inhaled Insulin, Oh My! Kevin M. Pantalone, DO, ECNU, CCD Associate Staff Director of Clinical Research Department of Endocrinology Endocrinology and
More informationCOMMISSIONING POLICY RECOMMENDATION TREATMENT ADVISORY GROUP Policy agreed by (Vale of York CCG/date)
Drug, Treatment, Device name ( Vipidia; Takeda) COMMISSIONING POLICY RECOMMENDATION TREATMENT ADVISORY GROUP Policy agreed by (Vale of York CCG/date) Licensed indication To improve glycaemic control in
More informationNon-insulin treatment in Type 1 DM Sang Yong Kim
Non-insulin treatment in Type 1 DM Sang Yong Kim Chosun University Hospital Conflict of interest disclosure None Committee of Scientific Affairs Committee of Scientific Affairs Insulin therapy is the mainstay
More informationMultiple Factors Should Be Considered When Setting a Glycemic Goal
Multiple Facts Should Be Considered When Setting a Glycemic Goal Patient attitude and expected treatment effts Risks potentially associated with hypoglycemia, other adverse events Disease duration Me stringent
More informationDept of Diabetes Main Desk
Dept of Diabetes Main Desk 01202 448060 Glucose management in Type 2 Diabetes in Adults The natural history of type 2 diabetes is for HbA1c to deteriorate with time. A stepwise approach to treatment is
More informationINJECTABLE THERAPY FOR THE TREATMENT OF DIABETES
INJECTABLE THERAPY FOR THE TREATMENT OF DIABETES ARSHNA SANGHRAJKA DIABETES SPECIALIST PRESCRIBING PHARMACIST OBJECTIVES EXPLORE THE TYPES OF INSULIN AND INJECTABLE DIABETES TREATMENTS AND DEVICES AVAILABLE
More informationLe incretine: un passo avanti. Francesco Dotta
Le incretine: un passo avanti Francesco Dotta U.O.C. Diabetologia, Policlinico Le Scotte Università di Siena Fondazione Umberto Di Mario ONLUS Toscana Life Science Park Incretins: multiple targets multiple
More informationProfessor Rudy Bilous James Cook University Hospital
Professor Rudy Bilous James Cook University Hospital Rate per 100 patient years Rate per 100 patient years 16 Risk of retinopathy progression 16 Risk of developing microalbuminuria 12 12 8 8 4 0 0 5 6
More informationpremix insulin and DPP-4 inhibitors what are the facts? New Sit2Mix trial provides first global evidence
Earn 3 CPD Points online Using a premix insulin (BIAsp 30) with a DPP-4 inhibitor what are the facts? New Sit2Mix trial provides first global evidence An important trial using a premix insulin (BIAsp 30)
More informationSummary. Introduction REVIEW ARTICLE. Johan Jendle 1 * George Grunberger 2 Thomas Blevins 3 Francesco Giorgino 4 Ryan T. Hietpas 5 Fady T.
REVIEW ARTICLE DIABETES/METABOLISM RESEARCH AND REVIEWS Diabetes Metab Res Rev 2016; 32: 776 790. Published online 15 May 2016 in Wiley Online Library (wileyonlinelibrary.com).2810 Efficacy and safety
More informationGlucagon-like peptide-1 (GLP-1) Agonists Drug Class Prior Authorization Protocol
Glucagon-like peptide-1 (GLP-1) Agonists Drug Class Prior Authorization Protocol Line of Business: Medicaid P&T Approval Date: February 21, 2018 Effective Date: April 1, 2018 This policy has been developed
More informationSponsor: Sanofi. According to template: QSD VERSION N 5.0 (04-APR-2016) Page 1
These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert in the country of prescription. Sponsor: Sanofi Drug substance(s):
More informationCan We Reduce Heart Failure by Treating Diabetes? CVOT Data on SGLT2 Inhibitors and GLP-1Receptor Agonists
Can We Reduce Heart Failure by Treating Diabetes? CVOT Data on SGLT2 Inhibitors and GLP-1Receptor Agonists Robert R. Henry, MD Professor of Medicine University of California, San Diego Relevant Conflict
More informationUpdate on Insulin-based Agents for T2D
Update on Insulin-based Agents for T2D Injectable Therapies for Type 2 Diabetes Mellitus (T2DM) and Obesity This presentation will: Describe established and newly available insulin therapies for treatment
More informationGLP-1-based therapies in the management of type 2 diabetes
GLP-1-based therapies in the management of type 2 diabetes Makbul Aman Mansyur Division Endocrine & Metabolism Department of Internal Medicine Faculty of Medicine Hasanuddin University/ RSUP Dr. Wahidin
More informationHorizon Scanning Technology Summary. Liraglutide for type 2 diabetes. National Horizon Scanning Centre. April 2007
Horizon Scanning Technology Summary National Horizon Scanning Centre Liraglutide for type 2 diabetes April 2007 This technology summary is based on information available at the time of research and a limited
More informationThese results are supplied for informational purposes only.
These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert in the country of prescription Sponsor/company: sanofi-aventis ClinialTrials.gov
More informationThis program applies to Commercial, GenPlus and Health Insurance Marketplace formularies.
OBJECTIVE The intent of the GLP-1 (glucagon-like peptide-1) Agonists [Adlyxin (lixisenatide), Byetta (exenatide), Bydureon (exenatide extended-release), Tanzeum (albiglutide), Trulicity (dulaglutide),
More informationUpdate on Insulin-based Agents for T2D. Harry Jiménez MD, FACE
Update on Insulin-based Agents for T2D Harry Jiménez MD, FACE Harry Jiménez MD, FACE Has received honorarium as Speaker and/or Consultant for the following pharmaceutical companies: Eli Lilly Merck Boehringer
More informationsitagliptin, 25mg, 50mg and 100mg film-coated tablets (Januvia ) SMC No. (1083/15) Merck Sharp and Dohme UK Ltd
sitagliptin, 25mg, 50mg and 100mg film-coated tablets (Januvia ) SMC No. (1083/15) Merck Sharp and Dohme UK Ltd 07 August 2015 The Scottish Medicines Consortium (SMC) has completed its assessment of the
More informationManagement of Type 2 Diabetes
Management of Type 2 Diabetes Pathophysiology Insulin resistance and relative insulin deficiency/ defective secretion Not immune mediated No evidence of β cell destruction Increased risk with age, obesity
More informationSemaglutide the new kid on the block in the field of glucagonlike peptide-1 receptor agonists?
Editorial Page 1 of 5 Semaglutide the new kid on the block in the field of glucagonlike peptide-1 receptor agonists? Cristian Guja 1,2, Rucsandra Dănciulescu Miulescu 1,2 1 National Institute of Diabetes,
More informationDisclosure. Learning Objectives. Case. Diabetes Update: Incretin Agents in Diabetes-When to Use Them? I have no disclosures to declare
Disclosure Diabetes Update: Incretin Agents in Diabetes-When to Use Them? I have no disclosures to declare Spring Therapeutics Update 2011 CSHP BC Branch Anar Dossa BScPharm Pharm D CDE April 20, 2011
More informationSponsor / Company: Sanofi Drug substance(s): HOE901-U300 (insulin glargine) According to template: QSD VERSION N 4.0 (07-JUN-2012) Page 1
These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert in the country of prescription. Sponsor / Company: Sanofi Drug substance(s):
More informationWhat s New in Type 2? Peter Hammond Consultant Physician Harrogate District Hospital
What s New in Type 2? Peter Hammond Consultant Physician Harrogate District Hospital Therapy considerations in T2DM Thiazoledinediones DPP IV inhibitors GLP 1 agonists Insulin Type Delivery Horizon scanning
More information23-Aug-2011 Lixisenatide (AVE0010) - EFC6014 Version number: 1 (electronic 1.0)
SYNOPSIS Title of the study: A randomized, double-blind, placebo-controlled, parallel-group, multicenter 24-week study followed by an extension assessing the efficacy and safety of AVE0010 on top of metformin
More informationGLP-1 Receptor Agonists and SGLT-2 Inhibitors. Debbie Hicks
GLP-1 Receptor Agonists and SGLT-2 Inhibitors Debbie Hicks Prescribing and Adverse Event reporting information is available at this meeting from the AstraZeneca representative The views expressed by the
More informationNCT Number: NCT
Efficacy and safety of insulin glargine 300 U/mL vs insulin degludec 100 U/mL in insulin-naïve adults with type 2 diabetes mellitus: Design and baseline characteristics of the BRIGHT study Alice Cheng
More informationPROTEZIONE DAL DANNO RENALE NEL DIABETE TIPO 2: RUOLO DEI NUOVI FARMACI. Massimo Boemi UOC Malattie Metaboliche e Diabetologia IRCCS INRCA Ancona
PROTEZIONE DAL DANNO RENALE NEL DIABETE TIPO 2: RUOLO DEI NUOVI FARMACI Massimo Boemi UOC Malattie Metaboliche e Diabetologia IRCCS INRCA Ancona Disclosure Dr Massimo Boemi has been granted as speaker
More informationegfr > 50 (n = 13,916)
Saxagliptin and Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus and Moderate or Severe Renal Impairment: Observations from the SAVOR-TIMI 53 Trial Supplementary Table 1. Characteristics according
More informationANNEX I SUMMARY OF PRODUCT CHARACTERISTICS
ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS 1 This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Healthcare professionals are asked
More informationOriginal. Shizuka Kaneko 1), Tomonori Oura 2), Akiko Matsui 2), Tomotaka Shingaki 2) and Masakazu Takeuchi 2)
2017, 64 (12), 1165-1172 Original Efficacy and safety of subgroup analysis stratified by baseline HbA1c in a Japanese phase 3 study of dulaglutide 0.75 mg compared with insulin glargine in patients with
More informationModulating the Incretin System: A New Therapeutic Strategy for Type 2 Diabetes
Modulating the Incretin System: A New Therapeutic Strategy for Type 2 Diabetes Geneva Clark Briggs, PharmD, BCPS Adjunct Professor at University of Appalachia College of Pharmacy Clinical Associate, Medical
More informationInitiating Injectable Therapy in Type 2 Diabetes
Initiating Injectable Therapy in Type 2 Diabetes David Doriguzzi, PA C Learning Objectives To understand current Diabetes treatment guidelines To understand how injectable medications fit into current
More informationIndividualizing Care for Patients with Type 2 Diabetes
Individualizing Care for Patients with Type 2 Diabetes Disclosures Speaker: AstraZeneca, Novo Nordisk, BI/Lilly, Valeritas, Takeda Advisor: Tandem Diabetes, Sanofi Objectives Develop individualized approaches
More informationSYNOPSIS. Administration: subcutaneous injection Batch number(s):
SYNOPSIS Title of the study: A randomized, double-blind, placebo-controlled, 2-arm parallel-group, multicenter 24-week study followed by an extension assessing the efficacy and safety of AVE0010 on top
More informationQuando l insulina basale non basta più: differenti e nuove strategie terapeutiche
Quando l insulina basale non basta più: differenti e nuove strategie terapeutiche Giorgio Sesti Università Magna Graecia di Catanzaro Potenziali conflitti di interesse Il Prof Giorgio Sesti dichiara di
More informationNo Increased Cardiovascular Risk for Lixisenatide in ELIXA
ON ISSUES IN THE MANAGEMENT OF TYPE 2 DIABETES JUNE 2015 Coverage of data from ADA 2015, June 5 9 in Boston, Massachusetts No Increased Cardiovascular Risk for Lixisenatide in ELIXA First Cardiovascular
More informationEfficacy/pharmacodynamics: 85 Safety: 89
These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert in the country of prescription. Sponsor/Company: Sanofi Drug substance:
More informationGlucose Control drug treatments
Glucose Control drug treatments It should be noted that glitazones are under suspicion of precipitating acute cardiac events and current recommendations contraindicate the use of glitazones in patients
More informationNew Drug Evaluation: Insulin degludec, subcutaneous injection
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationFaculty. Timothy S. Reid, MD (Co-Chair, Presenter) Medical Director Mercy Diabetes Center Janesville, WI
Activity Overview In this case-based webcast, meet Jackie, a 62-year-old woman with type 2 diabetes. Her glycated hemoglobin (HbA1C) is 9.2%, and she is taking 2 oral agents and basal insulin; however,
More informationMulti-factor approach to reduce cardiovascular risk in diabetes
Multi-factor approach to reduce cardiovascular risk in diabetes Prof. Nicola Napoli, MD PhD Division of Endocrinology and Diabetes Università Campus Bio-Medico di Roma Washington University in St Louis
More informationPHARMACOLOGIC APPROACH TO ACHIEVE GLYCEMIC GOAL
Dr Aurora Alcantara Endocrinology PHARMACOLOGIC APPROACH TO ACHIEVE GLYCEMIC GOAL SPED Convention and Diabetes Postgraduate Course May26-29 Wyndham Grand Rio Mar, PR DISCLOSURES Speaker for the following
More informationTimely!Insulinization In!Type!2! Diabetes,!When!and!How
Timely!Insulinization In!Type!2! Diabetes,!When!and!How, FACP, FACE, CDE Professor of Internal Medicine UT Southwestern Medical Center Dallas, Texas Current Control and Targets 1 Treatment Guidelines for
More informationinsulin degludec/liraglutide 100 units/ml / 3.6mg/mL solution for injection pre-filled pen (Xultophy ) SMC No. (1088/15) Novo Nordisk A/S
insulin degludec/liraglutide 100 units/ml / 3.6mg/mL solution for injection pre-filled pen (Xultophy ) SMC No. (1088/15) Novo Nordisk A/S 4 September 2015 The Scottish Medicines Consortium (SMC) has completed
More informationCombination treatment for T2DM
Combination treatment for T2DM Date of approval: December 2016 SAGLB.DIA.16.08.0657 Abbreviations ADA: American Diabetes Association CVD: Cardiovascular disease DPP-4: Dipeptidyl Peptidase-4 EASD: European
More informationUpdate on Diabetes Cardiovascular Outcome Trials
Update on Diabetes Cardiovascular Outcome Trials Jay S. Skyler, MD, MACP Division of Endocrinology, Diabetes, and Metabolism and Diabetes Research Institute University of Miami Miller School of Medicine
More informationTRANSPARENCY COMMITTEE
The legally binding text is the original French version TRANSPARENCY COMMITTEE Opinion 17 December 2014 JARDIANCE 10 mg, film-coated tablet B/30 tablets (CIP: 34009 278 928 5 1) JARDIANCE 25 mg, film-coated
More informationDu gusts is megl che one. Edoardo Mannucci
Du gusts is megl che one Edoardo Mannucci Conflitti di interessi Negli ultimi due anni, E. Mannucci ha ricevuto compensi per relazioni e/o consulenze da: Abbott, AstraZeneca, Boehringer Ingelheim, Eli
More informationBedtime-to-Morning Glucose Difference and iglarlixi in Type 2 Diabetes: Post Hoc Analysis of LixiLan-L
Diabetes Ther (2018) 9:2155 2162 https://doi.org/10.1007/s13300-018-0507-0 BRIEF REPORT Bedtime-to-Morning Glucose Difference and iglarlixi in Type 2 Diabetes: Post Hoc Analysis of LixiLan-L Ariel Zisman.
More informationScottish Medicines Consortium
Scottish Medicines Consortium saxagliptin, 5mg film-coated tablet (Onglyza ) No. (603/10) Bristol-Myers Squibb Pharmaceuticals Ltd 05 February 2010 The Scottish Medicines Consortium (SMC) has completed
More informationiglarlixi Reduces Glycated Hemoglobin to a Greater Extent Than Basal Insulin Regardless of Levels at Screening: Post Hoc Analysis of LixiLan-L
Diabetes Ther (2018) 9:373 382 https://doi.org/10.1007/s13300-017-0336-6 BRIEF REPORT iglarlixi Reduces Glycated Hemoglobin to a Greater Extent Than Basal Insulin Regardless of Levels at Screening: Post
More informationHave you seen a patient like Elaine *?
(linagliptin) 5mg tablets Have you seen a patient like Elaine *? *Hypothetical patient profile Elaine * : 60 years old Housewife *Hypothetical patient profile ELAINE*: T2D Patient with early signs of kidney
More informationCardiovascular Benefits of Two Classes of Antihyperglycemic Medications
Cardiovascular Benefits of Two Classes of Antihyperglycemic Medications Nathan Woolever, Pharm.D., Resident Pharmacist Pharmacy Grand Rounds November 6 th, 2018 Franciscan Healthcare La Crosse, WI 2017
More informationT max V d t 1/ hours 100 L 3 hours
Brand Name: Adlyxin Generic Name: lixisenatide Manufacturer: Sanofi-Aventis U.S. LLC 1 Drug Class: Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist 2,3,4 Uses: Labeled Uses 1,2,3,4,5 : Type 2 diabetes
More informationPresented By: Creative Educational Concepts, Inc. Lexington, KY
Disclaimer This slide deck in its original and unaltered format is for educational purposes and is current as of April 2015. The content and views presented in this educational activity are those of the
More informationThe Many Faces of T2DM in Long-term Care Facilities
The Many Faces of T2DM in Long-term Care Facilities Question #1 Which of the following is a risk factor for increased hypoglycemia in older patients that may suggest the need to relax hyperglycemia treatment
More informationCOPYRIGHT. Treatment of Type 2 Diabetes: What To Do When Treatment with Metformin is Inadequate? Can We Achieve Therapeutic Goals More Safely?
Treatment of Type 2 Diabetes: What To Do When Treatment with Metformin is Inadequate? Can We Achieve Therapeutic Goals More Safely? Martin J. Abrahamson, MD FACP Associate Professor of Medicine, Harvard
More informationSitagliptin: A component of incretin based therapy. Rezvan Salehidoost, M.D., Endocrinologist
Sitagliptin: A component of incretin based therapy Rezvan Salehidoost, M.D., Endocrinologist Agenda Mode of Action Evidences for sitagliptine cardiovascular safety of sitagliptin Ramadan study Impact of
More informationOral Hypoglycemics and Risk of Adverse Cardiac Events: A Summary of the Controversy
Oral Hypoglycemics and Risk of Adverse Cardiac Events: A Summary of the Controversy Jeffrey Boord, MD, MPH Advances in Cardiovascular Medicine Kingston, Jamaica December 7, 2012 VanderbiltHeart.com Outline
More informationA Practical Approach to the Use of Diabetes Medications
A Practical Approach to the Use of Diabetes Medications Juan Pablo Frias, M.D., FACE President, National Research Institute, Los Angles, CA Clinical Faculty, University of California, San Diego, CA OUTLINE
More informationSummary. Keywords GLP-1 receptor agonist; intensification; exenatide; lixisenatide; algorithms; latent autoimmune diabetes in adults (LADA)
DIABETES/METABOLISM RESEARCH AND REVIEWS Diabetes Metab Res Rev 2016. Published online in Wiley Online Library (wileyonlinelibrary.com).2775 REVIEW ARTICLE Treatment intensification in patients with inadequate
More informationOptimizing Treatment Strategies to Improve Patient Outcomes in the Management of Type 2 Diabetes
Optimizing Treatment Strategies to Improve Patient Outcomes in the Management of Type 2 Diabetes Philip Raskin, MD Professor of Medicine The University of Texas, Southwestern Medical Center NAMCP Spring
More informationIncredible Incretins Abby Frye, PharmD, BCACP
Incredible Incretins Abby Frye, PharmD, BCACP Objectives & Disclosures Review the pathophysiology of T2DM and the impact of the incretin system Describe the defining characteristics of the available glucagonlike
More informationEfficacy and Safety of Sitagliptin in Various Clinical Settings of T2DM
Efficacy and Safety of Sitagliptin in arious Clinical Settings of T2DM Young Min Cho, MD, PhD Division of Endocrinology and Metabolism Department of Internal Medicine Seoul National University College
More informationBristol-Myers Squibb / AstraZeneca ADVICE dapagliflozin (Forxiga ) Indication under review: SMC restriction: Chairman, Scottish Medicines Consortium
Re-Submission dapagliflozin 5mg and 10mg film-coated tablets (Forxiga ) SMC No. (799/12) Bristol-Myers Squibb / AstraZeneca 07 February 2014 The Scottish Medicines Consortium (SMC) has completed its assessment
More informationHave you seen a patient like Carol *?
(linagliptin) 5mg tablets Have you seen a patient like Carol *? *Hypothetical patient profile Carol * : 70 years old Retired schoolteacher *Hypothetical patient profile CAROL*: T2D patient with moderate
More information3/8/2011. Julie M. Sease, Pharm D, BCPS, CDE Associate Professor of Pharmacy Practice Presbyterian College School of Pharmacy
Summarize revisions to the 2011 American Diabetes Association clinical practice guidelines. Evaluate bromocriptine as a therapeutic option in the management of type 2 diabetes. Compare and contrast the
More information