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Novo Nordisk says Victoza outperforms SGLT2 inhibitors

Comparesthe GLP-1 agonist to Invokana, Jardiance and Farxiga

Novo Nordisk 

Danish drugmaker Novo Nordisk says its GLP-1 agonist Victoza has been shown to reduce blood sugar more effectively than SGLT2 inhibitors in an analysis of multiple clinical trials.

Victoza (liraglutide) was shown in the meta-analysis to provide a greater reduction in haemoglobin A1c - a measure of glucose control over time - and also helped more patients reach their treatment targets.

The analysis included 17 randomised controlled trials that included people with type 2 diabetes who were inadequately controlled with metformin alone or in combination with sulfonylurea, DPP4 inhibitors or glitazone drugs. 

It compared Victoza to the three marketed SGLT2 inhibitors - Johnson & Johnson's Invokana (canagliflozin), Lilly/Boehringer's Jardiance (empagliflozin) and AstraZeneca's Farxiga (dapagliflozin). 

Lead researchers Maria Lorenzi of Redwood Outcomes, a health economics specialist, said: "In the absence of head-to-head trials, this analysis provides valuable insight into the comparative outcomes with liraglutide versus SGLT-2 inhibitors in people with type 2 diabetes.”

The analysis is a boost for Victoza, which brought in sales of $2.4bn last year but is expected to come under pressure thanks to increasing competition in the diabetes sector. 

In particular, the recent EMPA-REG study showing that Jardiance was able to reduce cardiovascular death, non-fatal heart attack or non-fatal stroke in patients with diabetes is expected to drive use of the drug at the expense of other drug classes, including Victoza, which has a near 60% share of the GLP-1 agonist market.

The implication is that Jardiance could benefit by being used earlier on in diabetes therapy, pushing back the use of other drugs until later in the course of the disease.

Novo Nordisk has its own cardiovascular outcomes trial ongoing for Victoza - called LEADER - which is due to report results next year. 

There has however been speculation that one of the reasons Jardiance was able to show an impact was because it has a diuretic effect, in addition to cutting blood glucose and helping to reduce blood pressure and weight.

If that is the case, it could be harder for Victoza to demonstrate a significant impact on cardiovascular outcomes unless it has some other mechanism. Novo Nordisk has speculated that Victoza may have a direct effect on blood vessel wall pathology in diabetes, but has acknowledged that the chances of showing a survival benefit are far from assured.

Article by
Phil Taylor

3rd December 2015

From: Research

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