Effects of Exenatide Twice Daily and Once Weekly on Weight Loss

Abstract

Specific Aims: To determine the effectiveness of exenatide twice daily (ExBID) versus exentatide once weekly (ExQW) on weight loss in type II diabetes. Methods: This study was a meta-analysis. The studies used came from the PubMed database and Cochrane Reviews. To be included in the meta-analysis, studies must have been randomized controlled trials comparing ExBID to ExQW or drug to placebo. The studies that reported weight loss and/or HbA1C were included. Studies that included participants <18 years of age or compared only one dose of exenatide with other anti-diabetic medication without comparing to placebo were excluded. There were 13 studies that met the inclusion criteria and were included in the meta-analysis. The primary outcome was weight loss, and the secondary outcome was HbA1C levels. Meta-analysis was used to synthesize data. Main Results: The difference between ExQW and ExBID on weight loss was not statistically significant (standardized mean difference (SMD) = -0.71, CI -0.84 to -0.58 in ExQW vs SMD = 0.82, CI -1.02 to -0.62 in ExBID; p =0.36). The effect of ExQW on A1C was significantly larger than ExBID (SMD = -1.69 vs -1.07 respectively; p < 0.01). The variability was very high in the ExBID group (69% - 81%) compared to ExQW group (0%). Kendall’s tau was significant (p= 0.01) indicating that there may be publication bias. Conclusion: There is no difference in effect of weight loss between ExQW and ExBID group. Both dosages significantly improve A1C; however, ExBID has larger impact on A1C compared to ExBID.