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    New once-weekly treatment for type 2 DM

    Kathryn WheelerKathryn WheelerOn April 15, 2014, albiglutide (Tanzeum; GlaxoSmithKline) was approved for improvement of glycemic control in patients with type II diabetes in addition to diet and exercise. It is the newest glucagon-like peptide-1 receptor agonist (GLP-1) approved for once-weekly dosing. GLP-1 agonists stimulate glucose-dependent insulin release from the pancreas, slow gastric emptying, inhibit glucagon release, and promote satiety.

    As with all GLP-1 agonists, albiglutide has been associated with an increased risk of pancreatitis and possibly thyroid tumors. It has a boxed warning and a REMS program to ensure that the benefits of use outweigh the associated risks and that patients are informed of these risks. Information regarding the albiglutide REMS program can be found at www.tanzeumrems.com.

    Efficacy

    FDA approval of albiglutide was based on a series of eight trials, in which more than 2,000 participants with type 2 diabetes were treated with albiglutide. Albiglutide was investigated as both a monotherapy to be used in conjunction with diet and exercise, and as a combination therapy added to metformin; a sulfonylurea plus metformin; a thiazolidinedione with and without metformin; insulin glargine monotherapy; and insulin glargine plus other antidiabetic medications.

    These studies compared the efficacy of albuglutide to placebo or to an active therapy (sulfonylurea, dipeptidylpeptidase IV [DPP-IV] inhibitor, thiazolidinedione, and both rapid and long-acting insulins (lispro and glargine). Overall, albiglutde demonstrated a significant reduction in hemoglobin A1c without a significant participant weight reduction.

     A noninferiority study compared albiglutide to liraglutide, a once-daily GLP-1 agonist. In this open-label trial, participants taking liraglutide achieved greater reductions in A1c. However, participants receiving albiglutide experienced fewer gastrointestinal adverse effects and injection site reactions.

    Kathryn Wheeler, PharmD, BCPS
    Kathryn Wheeler, PharmD, BCPS, is assistant clinical professor of pharmacy practice, University of Connecticut School of Pharmacy, ...

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