Abstract 1239: Exenatide Once Weekly Elicited Improvements in Blood Pressure and Lipid Profile Over 52 Weeks in Patients with Type 2 Diabetes
Patients with type 2 diabetes (T2D) are at increased risk for cardiovascular disease (CVD). In previous studies, exenatide twice daily (BID) reduced A1C and body weight, which were accompanied by improvements in blood pressure and lipid profiles in patients with T2D. Here we report the effects of 52 wks of treatment with a once weekly (QW) formulation of exenatide (n=120, baseline A1C 8.3±1.0%, weight 103±19 kg, BMI 35.2±5.0 kg/m2; mean±SD). One year of treatment with exenatide QW resulted in improvement in A1C [−2.0±0.1% (LS mean±SE)] and weight loss (−4.1±0.6 kg). Significant improvements were demonstrated in both systolic (SBP) and diastolic (DBP) blood pressure (−6.2±1.2 mmHg and −2.8±0.8 mmHg respectively, from baseline 128/78 mmHg; p <0.05). In subjects with abnormal SBP (≥130 mmHg) at baseline (n=65, baseline 139/81 mmHg), even greater improvements in SBP (−11.4±1.9 mmHg, p <0.05) and DBP (−3.6±1.2 mmHg, p <0.05) were observed. At study initiation, 55% of patients had SBP <130 mmHg, while at Week 52, 71% of patients had SBP controlled to <130 mmHg. Analysis of SBP changes by weight-loss category (≥5%, <0%-<5%, and no weight loss) at 52 wks revealed that patients treated with exenatide QW had reduced SBP irrespective of weight loss (−6.7±2.3, −6.7±1.6, and −4.2±2.1 mmHg, respectively). Changes in concomitant antihypertensive medications were only allowed if deemed necessary by investigator. Favorable improvements in serum lipid profiles were also demonstrated [total cholesterol: −7.9±2.9 mg/dL (CI: −13.7, −2.0) from baseline 170 mg/dL; LDL-C: −2.2±2.4 (CI: −6.9, 2.5) from baseline 89 mg/dL; HDL-C: −0.3±0.8 (CI: −1.9, 1.3) from baseline 44 mg/dL; triglycerides: −40.1±111.5 (CI: −62.8, −17.3) from baseline 197 mg/dL; mean±SE]. Changes in BP and lipids were similar at 52 wks in patients treated with exenatide BID for 30 wks and then switched to exenatide QW for 22 wks. Exenatide QW was well tolerated; cumulative incidence of nausea, predominantly mild in intensity, occurred in 29% of subjects over 52 wks. In summary, treatment with exenatide QW for 52 wks was associated with significant improvements in glycemia, body weight, blood pressure (appearing to be independent of weight loss or concomitant antihypertensive medication changes), and lipid profiles.