Type 2 diabetes mellitus — compounds assessed
The 19 compounds the Institute assesses in type 2 diabetes mellitus.
§4Compounds assessed
Compounds the Institute assesses in this indication, with the class of each and its overall certainty. A compound appears here whether or not the evidence supports its use, because recording that a compound has been studied and found wanting is as much part of the assessment as recording that one has not.
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−1.1 to −1.9 % HbA1c across the AWARD programme; 4.5 mg gave −1.9 % in AWARD-11 — Eleven-trial programme with active comparators.
High -
GLP-1 receptor agonist (exendin-based, short- and extended-release)3 contributing trialsfull monograph
−0.8 to −1.9 % HbA1c depending on presentation and background therapy — Long clinical record; the extended-release presentation is superior to the immediate-release one for HbA1c.
High -
−1.1 to −1.5 % HbA1c at 26 weeks with 1.8 mg — Large and reproducible.
High -
−0.7 to −0.9 % HbA1c at 24 weeks with pronounced postprandial glucose reduction — Smaller HbA1c effect than the long-acting agents, with a distinctly different postprandial profile.
High -
−1.5 to −1.8 % HbA1c at 30–56 weeks versus placebo; superior to dulaglutide 1.5 mg in a head-to-head comparison — Dose-dependent, reproducible across background therapies.
High -
GLP-1 receptor agonist, oral formulation with absorption enhancer2 contributing trialsfull monograph
−1.2 to −1.4 % HbA1c at 26 weeks with 14 mg versus placebo — Ten-trial phase 3 programme with consistent dose-response.
High -
−1.87 to −2.59 % HbA1c across doses and backgrounds; superior to semaglutide 1.0 mg, insulin degludec and insulin glargine — Five-trial programme with active comparators throughout, an unusually strong design feature.
High -
Fixed-ratio combination of a long-acting amylin analogue and a GLP-1 receptor agonist1 contributing trialfull monograph
−13.7 % body weight and −1.8 % HbA1c at 68 weeks in type 2 diabetes — Attenuated weight effect in diabetes, consistent with the pattern seen across the incretin class.
Moderate -
−1.16 % HbA1c at 16 weeks with 120 mg twice daily versus placebo — Phase 2b; efficacy was established but did not exceed the injectable class.
Moderate -
Dual glucagon and GLP-1 receptor agonist (oxyntomodulin analogue)2 contributing trialsfull monograph
−1.8 % HbA1c at 24 weeks with 6 mg — Phase 3 in a Chinese population.
Moderate -
−2.1 % HbA1c at 26 weeks with 45 mg versus −0.4 % with placebo — Phase 2 dose-response with a clear gradient.
Moderate -
HbA1c −0.62 % versus −0.18 % with placebo at 52 weeks, with weight −1.4 kg — Insulin-treated type 2 diabetes.
Moderate -
−2.02 % HbA1c at 36 weeks with 12 mg versus −0.01 % with placebo; weight −16.9 % — Phase 2, active- and placebo-controlled with dulaglutide 1.5 mg as reference.
Moderate -
Combination with semaglutide 2.4 mg gave −15.6 % weight and −2.2 % HbA1c at 32 weeks — Attribution of effect between components is not resolvable from the reported design.
Low -
GIP receptor antagonist and GLP-1 receptor agonist conjugate (antibody–peptide)1 contributing trialfull monograph
−2.2 % HbA1c reported at 52 weeks in phase 2 — Small sample.
Low -
−1.7 % HbA1c at 16 weeks in phase 2 — Short duration; the cardiovascular outcome trial was recruiting at this cycle.
Low -
No human trial identified — —
Very low -
−1.8 % HbA1c reported at 24 weeks — Reporting incompleteness is itself the reason for the rating.
Very low -
No randomised controlled human trial identified — Rodent insulin-sensitivity findings only.
Very low
References cited on this page
References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.
- Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, Probstfield J, Riesmeyer JS, Riddle MC, Rydén L, Xavier D, Atisso CM, Dyal L, Hall S, Rao-Melacini P, Wong G, Avezum A, Basile J, Chung N, Conget I. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. The Lancet 2019;394(10193):121–130. doi:10.1016/S0140-6736(19)31149-3 · PMID 31189511
Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.