Liraglutide for Type 2 diabetes and obesity: a 2015 update

Abstract

Subcutaneous liraglutide (Victoza^®, Novo Nordisk) was approved for the treatment of Type 2 diabetes mellitus (T2DM) in Europe in 2009 and in the USA in 2010. In December 2014, liraglutide 3.0 mg was approved by the Food and Drug Administration (FDA) and in March 2015 by the European Medicines Agency (EMA) for the treatment of chronic weight management under the brand name Saxenda^® Novo Nordisk. Liraglutide causes a glucose-dependent increase in insulin secretion, decreases glucagon secretion and promotes weight loss by inhibiting appetite. Liraglutide probably induces satiety through activation of different areas in the hind brain and possibly by preserving free leptin levels. Recently, liraglutide has been suggested to protect against prediabetes and seems to prevent bone loss by increasing bone formation following diet-induced weight loss in obesity. This article not only covers the major clinical trials evaluating the effects of liraglutide in obesity and T2DM but also provides novel insights into the pharmacological mechanisms of liraglutide.

Keywords:

• efficacy
• GLP-1 receptor agonist
• obesity
• pre-diabetes
• safety
• T2DM
• tolerability

Financial and competing interests disclosure

JJ Holst has performed consulting services for Novo Nordisk. SS Torekov holds stocks in Novo Nordisk. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Liraglutide is a glucagon like peptide-1 (GLP-1) receptor analogue that enhances glucose-induced insulin secretion and inhibits glucagon secretion postprandially.

• Liraglutide administration 1.2 or 1.8 mg daily efficiently lowers blood glucose, body weight and systolic blood pressure both as monotherapy or as add-on therapy in T2DM patients.

• Liraglutide administration 1.8, 2.4 or 3.0 mg efficiently and dose dependently lowers body weight in non-diabetic obese individuals, as well as decreases the risk of prediabetes in this population.

• Approved for chronic weight management by the FDA in December 2014 and EMA in March 2015 with a dose of 3.0 mg daily.

• Imposes a very low risk of hypoglycemia and is generally well tolerated.

• Combination therapy with insulin degludec (IdegLira) has shown promising results and may serve as an efficient treatment strategy in T2DM.

• As for obesity management, liraglutide in combination with other appetite inhibiting hormones such as peptide YY, oxyntomodulin or glucagon may turn out to be the most powerful combination in future obesity management.