Long-term outcomes in patients with type 2 diabetes receiving glimepiride combined with liraglutide or rosiglitazone.

Sullivan SD, Alfonso-Cristancho R, Conner C, Hammer M, Blonde L

Cardiovascular diabetology26 Feb 2009Cited by 18 (Europe PMC)

PMID19245711PMCIDPMC2667489DOI10.1186/1475-2840-8-12PepBankPUB-19245711

Summary

BackgroundPoor control of type 2 diabetes results in substantial long-term consequences. Studies of new diabetes treatments are rarely designed to assess mortality, complication rates and costs. We sought to estimate the long-term consequences of liraglutide and rosiglitazone both added to glimepiride.MethodsTo estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes. Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes. CORE was calibrated to the LEAD-1 baseline patient characteristics. Survival, cumulative incidence of cardiovascular, ocular and renal events and healthcare costs were estimated over three periods: 10, 20 and 30 years.ResultsIn a hypothetical cohort of 5000 patients per treatment followed for 30 years, liraglutide 1.2 mg and 1.8 mg had higher survival rates compared to the group treated with rosiglitazone (15.0% and 16.0% vs. 12.6% after 30 years), and fewer cardiovascular, renal, and ocular events. Cardiovascular death rates after 30 years were 69.7%, 68.4% and 72.5%, for liraglutide 1.2 mg, 1.8 mg, and rosiglitazone, respectively. First and recurrent amputations were lower in the rosiglitazone group, probably due to a 'survival paradox' in the liraglutide arms (number of events: 565, 529, and 507, respectively). Overall cumulative costs per patient, were lower in both liraglutide groups compared to rosiglitazone (US$38,963, $39,239, and $40,401 for liraglutide 1.2 mg, 1.8 mg, and rosiglitazone, respectively), mainly driven by the costs of cardiovascular events in all groups.ConclusionUsing data from LEAD-1 and epidemiologic evidence from the CORE diabetes model, projected rates of mortality, diabetes complications and healthcare costs over the long term favor liraglutide plus glimepiride over rosiglitazone plus glimepiride.Trial registrationLEAD-1 NCT00318422; LEAD-2 NCT00318461; LEAD-3 NCT 00294723; LEAD-4 NCT00333151; LEAD-5 NCT00331851; LEAD-6 NCT00518882.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study10

10 results from studies that gave the peptide. No result from this study comes from people.

01Computer modelIn silicoEfficacy outcome
In a simulated cohort of 5000 patients with type 2 diabetes on glimepiride, liraglutide 1.2 mg gave 15.0% survival at 30 years versus 12.6% with rosiglitazone.
In plain wordsA computer model projected that more patients on liraglutide 1.2 mg would be alive after 30 years than on rosiglitazone.
Peptide
Liraglutide
Outcome
IncreaseSurvival at 30 years
Study
n: not reported in source
CORE diabetes model
Comparator
Rosiglitazone 4 mg plus glimepiride
Outcome group
Mortality · Whole body
Studied dose
1.2 mg · 30 years (simulated)As given in this study.
Measurements
30-year survival
15%
liraglutide 1.2 mg
30-year survival
12.6%
rosiglitazone
Source sentences
Summary
In a hypothetical cohort of 5000 patients per treatment followed for 30 years, liraglutide 1.2 mg and 1.8 mg had higher survival rates compared to the group treated with rosiglitazone (15.0% and 16.0% vs. 12.6% after 30 years), and fewer cardiovascular, renal, and ocular events.
2 context sentences(design, population, supporting numbers)
Summary · context
To estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes.
Summary · context
Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes.
Show in the study text Report a problemFND-1924571101
02Computer modelIn silicoEfficacy outcome
In a simulated cohort of 5000 patients with type 2 diabetes on glimepiride, liraglutide 1.8 mg gave 16.0% survival at 30 years versus 12.6% with rosiglitazone.
In plain wordsA computer model projected that more patients on liraglutide 1.8 mg would be alive after 30 years than on rosiglitazone.
Peptide
Liraglutide
Outcome
IncreaseSurvival at 30 years
Study
n: not reported in source
CORE diabetes model
Comparator
Rosiglitazone 4 mg plus glimepiride
Outcome group
Mortality · Whole body
Studied dose
1.8 mg · 30 years (simulated)As given in this study.
Measurements
30-year survival
16%
liraglutide 1.8 mg
30-year survival
12.6%
rosiglitazone
Source sentences
Summary
In a hypothetical cohort of 5000 patients per treatment followed for 30 years, liraglutide 1.2 mg and 1.8 mg had higher survival rates compared to the group treated with rosiglitazone (15.0% and 16.0% vs. 12.6% after 30 years), and fewer cardiovascular, renal, and ocular events.
2 context sentences(design, population, supporting numbers)
Summary · context
To estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes.
Summary · context
Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes.
Show in the study text Report a problemFND-1924571102
03Computer modelIn silicoEfficacy outcome
In a simulated cohort of patients with type 2 diabetes, liraglutide 1.2 mg and 1.8 mg gave fewer cardiovascular events than rosiglitazone.
In plain wordsA computer model projected fewer heart and blood vessel events with liraglutide than with rosiglitazone.
Peptide
Liraglutide
Outcome
DecreaseCardiovascular events
Study
n: not reported in source
CORE diabetes model
Comparator
Rosiglitazone 4 mg plus glimepiride
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
1.2 mg and 1.8 mg · 30 years (simulated)As given in this study.
Source sentences
Summary
In a hypothetical cohort of 5000 patients per treatment followed for 30 years, liraglutide 1.2 mg and 1.8 mg had higher survival rates compared to the group treated with rosiglitazone (15.0% and 16.0% vs. 12.6% after 30 years), and fewer cardiovascular, renal, and ocular events.
2 context sentences(design, population, supporting numbers)
Summary · context
To estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes.
Summary · context
Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes.
Show in the study text Report a problemFND-1924571103
04Computer modelIn silicoEfficacy outcome
In a simulated cohort of patients with type 2 diabetes, liraglutide 1.2 mg and 1.8 mg gave fewer renal events than rosiglitazone.
In plain wordsA computer model projected fewer kidney events with liraglutide than with rosiglitazone.
Peptide
Liraglutide
Outcome
DecreaseRenal events
Study
n: not reported in source
CORE diabetes model
Comparator
Rosiglitazone 4 mg plus glimepiride
Outcome group
Kidney function · Kidney and urinary
Studied dose
1.2 mg and 1.8 mg · 30 years (simulated)As given in this study.
Source sentences
Summary
In a hypothetical cohort of 5000 patients per treatment followed for 30 years, liraglutide 1.2 mg and 1.8 mg had higher survival rates compared to the group treated with rosiglitazone (15.0% and 16.0% vs. 12.6% after 30 years), and fewer cardiovascular, renal, and ocular events.
2 context sentences(design, population, supporting numbers)
Summary · context
To estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes.
Summary · context
Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes.
Show in the study text Report a problemFND-1924571104
05Computer modelIn silicoEfficacy outcome
In a simulated cohort of patients with type 2 diabetes, liraglutide 1.2 mg and 1.8 mg gave fewer ocular events than rosiglitazone.
In plain wordsA computer model projected fewer eye events with liraglutide than with rosiglitazone.
Peptide
Liraglutide
Outcome
DecreaseOcular events
Study
n: not reported in source
CORE diabetes model
Comparator
Rosiglitazone 4 mg plus glimepiride
Outcome group
Diabetes complications · Eye
Studied dose
1.2 mg and 1.8 mg · 30 years (simulated)As given in this study.
Source sentences
Summary
In a hypothetical cohort of 5000 patients per treatment followed for 30 years, liraglutide 1.2 mg and 1.8 mg had higher survival rates compared to the group treated with rosiglitazone (15.0% and 16.0% vs. 12.6% after 30 years), and fewer cardiovascular, renal, and ocular events.
2 context sentences(design, population, supporting numbers)
Summary · context
To estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes.
Summary · context
Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes.
Show in the study text Report a problemFND-1924571105
06Computer modelIn silicoEfficacy outcome
In a simulated cohort of patients with type 2 diabetes, cardiovascular death at 30 years was 69.7% with liraglutide 1.2 mg versus 72.5% with rosiglitazone.
In plain wordsA computer model projected a lower rate of heart-related death with liraglutide 1.2 mg than with rosiglitazone.
Peptide
Liraglutide
Outcome
DecreaseCardiovascular death rate at 30 years
Study
n: not reported in source
CORE diabetes model
Comparator
Rosiglitazone 4 mg plus glimepiride
Outcome group
Mortality · Cardiovascular
Studied dose
1.2 mg · 30 years (simulated)As given in this study.
Measurements
CV death rate at 30 years
69.7%
liraglutide 1.2 mg
CV death rate at 30 years
72.5%
rosiglitazone
Source sentences
Summary
Cardiovascular death rates after 30 years were 69.7%, 68.4% and 72.5%, for liraglutide 1.2 mg, 1.8 mg, and rosiglitazone, respectively.
2 context sentences(design, population, supporting numbers)
Summary · context
To estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes.
Summary · context
Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes.
Show in the study text Report a problemFND-1924571106
07Computer modelIn silicoEfficacy outcome
In a simulated cohort of patients with type 2 diabetes, cardiovascular death at 30 years was 68.4% with liraglutide 1.8 mg versus 72.5% with rosiglitazone.
In plain wordsA computer model projected a lower rate of heart-related death with liraglutide 1.8 mg than with rosiglitazone.
Peptide
Liraglutide
Outcome
DecreaseCardiovascular death rate at 30 years
Study
n: not reported in source
CORE diabetes model
Comparator
Rosiglitazone 4 mg plus glimepiride
Outcome group
Mortality · Cardiovascular
Studied dose
1.8 mg · 30 years (simulated)As given in this study.
Measurements
CV death rate at 30 years
68.4%
liraglutide 1.8 mg
CV death rate at 30 years
72.5%
rosiglitazone
Source sentences
Summary
Cardiovascular death rates after 30 years were 69.7%, 68.4% and 72.5%, for liraglutide 1.2 mg, 1.8 mg, and rosiglitazone, respectively.
2 context sentences(design, population, supporting numbers)
Summary · context
To estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes.
Summary · context
Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes.
Show in the study text Report a problemFND-1924571107
08Computer modelIn silicoEfficacy outcome
In a simulated cohort of patients with type 2 diabetes, amputations were lower with rosiglitazone than with liraglutide (565 and 529 events with liraglutide 1.2 mg and 1.8 mg versus 507), which the authors attribute to a survival paradox.
In plain wordsA computer model projected more amputations with liraglutide than with rosiglitazone; the authors link this to longer survival on liraglutide.
Peptide
Liraglutide
Outcome
IncreaseFirst and recurrent amputations
Study
n: not reported in source
CORE diabetes model
Comparator
Rosiglitazone 4 mg plus glimepiride
Outcome group
Diabetes complications · Whole body
Studied dose
1.2 mg and 1.8 mg · 30 years (simulated)As given in this study.
Measurements
amputation events
565 events
liraglutide 1.2 mg
amputation events
529 events
liraglutide 1.8 mg
amputation events
507 events
rosiglitazone
Source sentences
Summary
First and recurrent amputations were lower in the rosiglitazone group, probably due to a 'survival paradox' in the liraglutide arms (number of events: 565, 529, and 507, respectively).
2 context sentences(design, population, supporting numbers)
Summary · context
To estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes.
Summary · context
Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes.
Show in the study text Report a problemFND-1924571108
09Computer modelIn silicoEfficacy outcome
In a simulated cohort of patients with type 2 diabetes, cumulative cost per patient was lower with liraglutide 1.2 mg (US$38,963) than with rosiglitazone (US$40,401).
In plain wordsA computer model projected lower overall costs per case with liraglutide 1.2 mg than with rosiglitazone.
Peptide
Liraglutide
Outcome
DecreaseCumulative cost per patient
Study
n: not reported in source
CORE diabetes model
Comparator
Rosiglitazone 4 mg plus glimepiride
Outcome group
Healthcare costs and utilization · Whole body
Studied dose
1.2 mg · 30 years (simulated)As given in this study.
Measurements
cumulative cost per patient
38,963 US$
liraglutide 1.2 mg
cumulative cost per patient
40,401 US$
rosiglitazone
Source sentences
Summary
Overall cumulative costs per patient, were lower in both liraglutide groups compared to rosiglitazone (US$38,963, $39,239, and $40,401 for liraglutide 1.2 mg, 1.8 mg, and rosiglitazone, respectively), mainly driven by the costs of cardiovascular events in all groups.
2 context sentences(design, population, supporting numbers)
Summary · context
To estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes.
Summary · context
Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes.
Show in the study text Report a problemFND-1924571109
10Computer modelIn silicoEfficacy outcome
In a simulated cohort of patients with type 2 diabetes, cumulative cost per patient was lower with liraglutide 1.8 mg (US$39,239) than with rosiglitazone (US$40,401).
In plain wordsA computer model projected lower overall costs per case with liraglutide 1.8 mg than with rosiglitazone.
Peptide
Liraglutide
Outcome
DecreaseCumulative cost per patient
Study
n: not reported in source
CORE diabetes model
Comparator
Rosiglitazone 4 mg plus glimepiride
Outcome group
Healthcare costs and utilization · Whole body
Studied dose
1.8 mg · 30 years (simulated)As given in this study.
Measurements
cumulative cost per patient
39,239 US$
liraglutide 1.8 mg
cumulative cost per patient
40,401 US$
rosiglitazone
Source sentences
Summary
Overall cumulative costs per patient, were lower in both liraglutide groups compared to rosiglitazone (US$38,963, $39,239, and $40,401 for liraglutide 1.2 mg, 1.8 mg, and rosiglitazone, respectively), mainly driven by the costs of cardiovascular events in all groups.
2 context sentences(design, population, supporting numbers)
Summary · context
To estimate long-term clinical and economic consequences, we used the CORE diabetes model, a validated cohort model that uses epidemiologic data from long-term clinical trials to simulate morbidity, mortality and costs of diabetes.
Summary · context
Clinical data were extracted from the LEAD-1 trial evaluating two doses (1.2 mg and 1.8 mg) of a once daily GLP-1 analog liraglutide, or rosiglitazone 4 mg, on a background of glimepiride in type 2 diabetes.
Show in the study text Report a problemFND-1924571110

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Registered trials6

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

6 trials · 5 completed · 1 stopped early · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT00518882