Liraglutide: bench to bedside

Abstract

Good glycaemic control in type 2 diabetes can be achieved by current medications, but often at the expense of hypoglycaemia and weight gain. The glucose-dependent stimulation of insulin secretion, the reduction in appetite and the improvement in β-cell function with glucagon-like peptide-1 (GLP-1), suggest that incretin-based therapies could be an attractive pharmacological target for treatment of type 2 diabetes. Encouraging results with liraglutide from clinical pharmacology trials and phase 2 trials led to a well-designed, comprehensive, phase 3 clinical programme comprising six large randomised controlled trials - The Liraglutide Effect and Action on Diabetes (LEAD) programme. The purpose of the LEAD programme was to investigate the clinical efficacy and safety of liraglutide as monotherapy or in combination with commonly used treatments in patients with type 2 diabetes. The application of liraglutide across the continuum of progression of type 2 diabetes was thoroughly evaluated in the LEAD trials. Overall, the LEAD programme demonstrated that once-daily liraglutide improved glycaemic control, decreased body weight with minimal risk of hypoglycaemia and was well tolerated in patients with type 2 diabetes. It also showed that liraglutide reduced systolic blood pressure (SBP) and promoted β-cell function. Liraglutide is a novel drug that can address the current unmet medical needs in the early treatment of diabetes, both as a monotherapy and as an add-on therapy to conventional type 2 diabetes therapies.