Diabetes Drugs Go Head-to-Head

Victoza and Bydureon for type 2 diabetes lower blood sugar and promote weight loss

(RxWiki News) In many cases, patients with type 2 diabetes can control their disease through diet and exercise. When these lifestyle changes aren't enough, patients may need drug treatment. But which drug works best?

A recent trial showed that Victoza (liraglutide) worked slightly better than Bydureon (exenatide) at lowering blood sugar and furthering weight loss in patients with type 2 diabetes.

However, patients taking Bydureon experienced fewer harmful side effects.

"Ask your doctor which diabetes drug is best for you."

According to John B. Buse, MD, PhD, of the University of North Carolina School of Medicine and first author of the study, both of these drugs are good at lowering blood sugar. Victoza is an injection taken once a day to help lower blood sugar levels in adults with type 2 diabetes. Bydureon is also an injection to lower blood sugar but needs to be taken only once a week.

From their study, Dr. Buse and colleagues found that both drugs led to a significant drop in levels of HbA1c - a measure of blood sugar over time.

After 26 weeks of treatment, 60 percent of patients taking Victoza reached HbA1c levels of less than 7 percent - the recommended target for patients with type 2 diabetes. In comparison, 53 percent of patients taking Bydureon reached an HbA1c of less than 7 percent.

An HbA1c of less than 5.7 percent is considered normal. People with an HbA1c of 6.5 percent or higher are said to have diabetes.

In the study, patients taking Victoza lowered their HbA1c by about 1.48 percent, which was more than the reduction of 1.28 percent among patients taking Bydureon.

While lowering blood sugar is often the main goal of diabetes treatment, losing weight is also key to managing the disease. Both Victoza and Bydureon led to weight loss. However, patients taking Victoza lost about two pounds more than their counterparts taking Bydureon.

Patients taking either drug experienced side effects, the most common of which were nausea, vomiting and diarrhea. Patients taking Victoza experienced more of these side effects than patients taking Bydureon.

Nausea affected 21 percent of Victoza patients and 9 percent of Bydureon patients. Vomiting affected 11 percent of Victoza patients and 4 percent of Bydureon patients. Diarrhea affected 13 percent of Victoza patients and 6 percent of Bydureon patients.

“The results of this study will be helpful to both doctors and patients in shared decision-making about which of these two drugs is better suited for a particular patient,” said Dr. Buse.

“For example, for some patients, the additional weight loss advantage provided by [Victoza] might tip the scales in favor of that drug. For other patients, though, the greater convenience of once-weekly injections and the more favorable side effects profile of [Bydureon] would be extremely appealing," he said.

This randomized clinical trial included 450 patients taking Victoza and 461 taking Bydureon.

A year's supply of Victoza may cost between $3,000 and $5,000. Bydureon costs about $4,200 per year.

Both Victoza and Bydureon come with black box warnings of potentially serious side effects. In studies on rodents, both drugs led to the development of tumors on the thyroid gland. The research was funded by Eli Lilly and Amylin Pharmaceuticals. Amylin is the manufacturer of Bydureon. The study was published November 7 in The Lancet

Review Date: 
November 5, 2012