New Drug for Type 2 Diabetes: Victoza (liraglutide)

Reuters reported on January 25, 2009, the U.S. Food and Drug Administration’s recent approval of liraglutide (brand name: Victoza).

It joins Byetta (exenatide) as the second  GLP-1 (glucagon-like peptide-1) analog available in the U.S.  Both are injections and work by stimulating the release of insulin by pancreas beta cells when blood sugar is too high. 

The FDA indicated liraglutide is not generally a first-choice drug for diabetes.

It’s always good to have options.

Steve Parker, M.D.

6 Comments

Filed under Drugs for Diabetes

6 responses to “New Drug for Type 2 Diabetes: Victoza (liraglutide)

  1. It seems to me that given the cost of these GLP analogs, the case for lap-band becomes stronger and stronger. I can see insurance not covering lap-band vs metformin, but if they’re going to cover these, I’d wager the long term cost of lap-band is lower than these peptides. It’d be interesting to see someone do a cost comparison over a 5 or 10 year period.

  2. Interesting outlook, Isaac. I have no idea how much the GLP-1’s cost.

    I predict that Dr. Richard Bernstein, author of “The Diabetes Solution” would not favor GLP-1’s since they stimulate pancreas beta cells, potentially contributing to, or accelerating, “beta cell burn-out.” Exogenous insulin, on the other hand, helps preserve beta cell function, he would argue.

    -Steve

  3. I remember thinking the same thing but in animal models, at least, the GLP analogs seem to preserve the beta cells unlike the sulfonylureas. I seem to recall the claim was that it increased neoplasticity of the beta cells. How strong that data is or whether it applies to humans is unknown. Rodent beta cells are much more plastic than humans but it is possible.

  4. GLP-1’s are also attractive to some overweight diabetics because they seem to promote loss of excess weight in some of them. I’m thinking of David Mendoza, a diabetic who often blogs on diabetes-related issues (Diabetes Developments on my blogroll).

  5. The weight part is intriguing. We played around with GLP a bit. Let me tell ya. From a researcher’s end, it’s a nightmare to work with something that induces nausea and reduces food consumption but is NOT toxic. How in the world do you test that in animals? How do you know if the animal isn’t eating because it’s sick (toxicity) or it just doesn’t feel like it? You can’t just walk up and ask them. And how does nausea not equal toxic? Usually, nausea is a bad thing. That’s a hard thing to decipher.

    I have to give credit to Amylin’s scientists for being confident enough in their data to make that call with a then novel mechanism. That’s not an easy decision to make. It’s a fascinating pathway and if the industry is fortunate (hopefully, they will be), there’ll be some more therapies that come out of these neuro/liver/gut axis of hormones.

    The cost for Byetta is about $2,000/year for twice daily injections (some people can get by on one). Lap band is around $10 to 15 grand. After 5 to 7 years, the lap band is paid for compared to Byetta and that assumes that the Byetta is a monotherapy (nevermind their A1c will come down a lot more with lap-band). If their doctor is smart, the patient is also on an antihypertensive and statin. Odds are they’re also on metformin. If lap band reduces the need for all of those, then it pays for itself even quicker.

  6. Heather

    The problem with insurance covering drugs and not lap bands is insurances are assuming that a person will only be on their coverage for 2-3 years tops. Most people jump insurances as they change jobs or the companies change insurance companies.