Looking ‘Beyond Metformin’

At the press conference, Robert H. Eckel, MD, session moderator from the University of Colorado, Aurora, explained that the majority of clinicians currently agree that under most circumstances, metformin is the drug of choice for patients with type 2 diabetes.

“Now, with EMPA-REG published a year ago and ultimately now LEADER, we have to think beyond metformin in terms of what that second drug of choice might be,” he said.

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Dr Eckel added that one of the questions that often comes up in the LEADER and EMPA-REG trials is whether the observed effect is the result of a class effect or the molecule.

“Ultimately, validation of studies like this are incredibly important and studies are ongoing with other [sodium glucose cotransporter-2] inhibitors to see whether or not we can validate EMPA-REG,” he said. “In LEADER, we already have a hint that there is another drug in this class that appears to be beneficial.”

Disclosures: LEADER was funded by Novo Nordisk and grants from the National Institutes of Health. Dr Buse’s is a consultant and stock/shareholder  for PhaseBio; has received research support from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, GI Dynamics, Intarcia, J&J, Lexicon, Medtronic, Novo Nordisk, Orexigen, Sanofi, Scion NeuroStim, Takeda, and Theracos; and is an advisor under contract between employer and company for Adocia, AstraZeneca, Dance Biopharm, Eli Lilly, Elycylex, F. Hoffman LaRoche, GI Dynamics, Lexicon, Merck, Metavention, Novo Nordisk, Orexigen, Quest, Takeda, and vTv Therapeutics. Dr Zinman is a consultant for and has received honoraria from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, and Sanofi, and has received grant support from Boehringer Ingelhiem, Novo Nordisk, and AstraZeneca.

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  1. Marso SP, Daniels GH, Brown-Frandsen KB, et al; for the LEADER Steering Committee on behalf of the LEADER Trial Investigators. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016;doi:10.1056/nejmoa1603827.
  2. 3-CT-SY24 – Results of the Liraglutide Effect and Action in Diabetes—Evaluation of Cardiovascular Outcome Results (LEADER) Trial. Presented at: ADA 76th Scientific Sessions; June 10-14, 2016; New Orleans, LA. 

This article originally appeared on Endocrinology Advisor