Lilly Diabetes Drug Shows a Life-Extending Promise

The ACCORD trial results were no suprise to our diabetes practice. We have been heavy users of Byetta since launch in 2005, and have seen the same results in our population of > 2000 diabetics with over 700 on Byetta. Since the Simpson et al study in the Canadian Journal of Medicine (CMAJ 2006;174(2):169-74) showing an increase in mortality with sulfonyurea from 1.3 to 2.1 fold, but a decrease...

This will probably help Byetta sales modestly. However, the numbers ere small, it was a non-randomized comparison, and may be that Byetta use was a surrogate for less sulfonurea use, lower doses of insulin or no insulin at all (any of which may be harmful). However, the main barrier to more widespread Byetta use is the need for BID injections and the training required. These data may provide more...

Very interesting results; Need more information. Did Janumet also result in weight loss? does weight loss disappear after a while? Was weight loss associated with an improvement in cardiovascular hemodynamics, lipid profile and elasticity of blood vessels; it will be interesting to see if the secondary features of diabetes mellitus will also be eliminated with Byetta. it will be interesting also to...

In a small subgroup of type-2-diabetes patients  in the ACCORD trial which had been treated with Byetta (825 of 10 000) a lowerde death rate was found as compared to the whole group.  This is a hypothesis-generating finding. Fewer hypoglycemias, even mild ones, may be an exüplanation for this result which, however, awaits bigger studies planned to answer this question 

Posthoc analyses are notorious for turning up observations that cannot be confirmed when formally tested Clinicians should base their treatment choices on facts not supposition In the unlikely case that Byetta does turn out to confer a survival advantage it is likely that oral DP4 inhibitors like Januvia will have the same benefits Hence this doesnt take away the problem that Byetta is injectable...

1. The efficacy is not not know about life exdending ( may be the results are coming from heakthy person), so it is not clear. 2. Patient taking injection 2 times is not feasible for long run basis. 3. It  is not monotherapy.

The recent finding that Byetta therapy decreased mortality in the ACCORD study needs to be replicated in studies designed to address that point.  Even if it is replicated and statistically significant, it probably will not be true for the widely anticipated once weekly extended formulation of the drug.

This was a great NYT story.  The fact that Byetta was suggested as cardioprotective out of ACCORD was truly ignored by the media and nice to see the suggestion here. FDA is moving much more this direction and from a patient perspective, having a cardioprotective drug (LAR) that is easier to take than insulin (no hypo, no weight gain, 2% A1c drop) will be shown to be revolutionary.