Novo Nordisk’s Victoza boosted by Januvia switch trial data

Switching from Merck & Co’s Januvia (sitagliptin) to Novo Nordisk’s Victoza (liraglutide) produced superior blood sugar reductions than continuing with the same treatment, according to latest trial data from the Danish pharma company.

Novo Nordisk also announced encouraging phase 3 data from its investigational drug semaglutide, which like Victoza is a GLP-1 class drug, but can be administered by injection weekly, not daily.

Victoza is a key sales growth driver for Novo Nordisk. In 2015, sales were around $2.75 billion, a reported increase of 34% compared with 2014.

The 26-week LIRA-SWITCH trial in adults assessed efficacy and safety of Victoza 1.8mg as an add-on to metformin in 407 adults with type 2 diabetes who switched from the DPP-4 inhibitor Januvia 100mg and metformin.

Of the 407 adults uncontrolled on Januvia at week 26, those who switched to Victoza achieved a superior reduction HbA1c compared with those who continued their Januvia treatment.

Those on Victoza had reduced HbA1c by 1.14%, compared with those in a Januvia group, whose HbA1c fell by 0.54%.

Those who switched to Victoza experienced significantly greater body weight reductions versus those who continued with sitagliptin.

On Victoza, 50.6% achieved HbA1c below 7%, compared with 26.9% of those on Januvia. On Victoza, 29.5% achieved HbA1c of 6.5% or below, compared with 9.9% on Januvia.

Adverse events were more common in the Victoza group compared with Januvia (68.8% vs 56.9%) but there were no reports of severe hypoglycaemia and no reports of confimed nocturnal hypoglycaemia.

Meanwhile Novo said its semaglutide 0.5mg and 1mg achieved significantly greater HbA1c reductions compared with placebo in a trial involving 388 adults.

In the SUSTAIN 1 trial 74% of those on the lower strength and 72% of those on the higher strength achieved HbA1C below 7%. On the lower strength 59% of patients achieved HbA1c at or below 6.5%, compared with 60% on the higher dose, versus 25% on a placebo arm.

The most common adverse events were gastrointestinal and were mainly mild and moderate in all groups. Nausea occurred in 20.3% and 23.8% of the low and high dose semaglutide groups respectively, compared with 2.3% in the placebo groups.

There were comparable rates of serious adverse events in semaglutide, low dose, high dose and placebo respectively (6.3% and 5.4% vs 2.3%).

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