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Determining predictors of response to exenatide in type 2 diabetes
Sarah L Anderson1, Jennifer M Trujillo, Michael McDermott
1School of Pharmacy, University of Colorado, 12850 E. Montview Blvd., Aurora, CO 80045, USA. sarah.anderson@ucdenver.edu
Objectives:
To determine predictors of glycemic response to exenatide and to assess change in glycosylated hemoglobin (A1C) and whether a correlation exists between weight loss and glycemic response.
Design:
Retrospective observational cohort study.
Setting:
United States in 2009.
Patients:
100 adult patients with type 2 diabetes prescribed exenatide.
Intervention:
Retrospective chart review of patients to collect demographic data, weight, serum creatinine, diabetes education, and concurrent diabetes medications.
Main Outcome Measures:
Patients were categorized as responders or nonresponders based on change in A1C. Responders had an A1C decrease of 0.5% or more and nonresponders had an A1C decrease of less than 0.5% from baseline to post-exenatide initiation. Demographic data for each cohort were analyzed.
Results:
100 patients met inclusion criteria (61 responders and 39 nonresponders). Responders had a mean A1C decrease of 1.57%, whereas nonresponders had a mean A1C increase of 0.23% (P < 0.001). Post hoc linear regression analysis revealed that baseline A1C was a predictor of response to exenatide (P < 0.001). Binary logistic regression analysis demonstrated that no other variables were predictors of response to exenatide (P > 0.05 for all). No correlation was found between weight loss and exenatide and glycemic response (P = 0.99).
Conclusion:
Our data indicate that patients with a higher baseline A1C are more likely to have a glycemic response to exenatide than patients with a lower baseline A1C.
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