Pancreatic Safety of Once-Weekly Dulaglutide in Chinese Patients with Type 2 Diabetes Mellitus: Subgroup Analysis by Potential Influencing Factors

Abstract

In the randomized, open-label, parallel-arm, active-controlled phase III AWARD-CHN2 trial, once-weekly dulaglutide plus concomitant oral antihyperglycemic medications (OAMs) improved HbA1c over 26 weeks compared with once-daily insulin glargine in patients with type 2 diabetes mellitus (T2DM). This post-hoc subgroup analysis of AWARD-CHN2 investigated the pancreatic safety of dulaglutide in Chinese patients with T2DM, stratified by potential influencing factors. Changes in pancreatic enzyme (pancreatic amylase, total amylase, and lipase) levels over 26 weeks were assessed and stratified by patient age (<\u200960, ≥\u200960 years), sex (female, male), duration of diabetes (<\u200910, ≥\u200910 years), baseline weight (<\u200970, ≥\u200970 kg), BMI (<\u200925, ≥\u200925 kg/m2), HbA1c (<\u20098.5, ≥\u20098.5%), triglycerides (<\u20092.3, ≥\u20092.3 mmol/L), and concomitant OAMs (metformin, sulfonylurea, metformin plus sulfonylurea). A total of 203 Chinese patients with T2DM were included in this post-hoc analysis. Pancreatic enzyme levels increased within the normal range from baseline to Week 26, and no pancreatitis events were confirmed by independent adjudication. Least-squares mean increase in pancreatic amylase (U/L) from baseline to Week 26 was comparable across all subgroups with no statistically (all P-values\u2009>\u20090.05) or clinically significant between-group differences for age (<\u200960 years: 5.34;\u2009≥\u200960 years: 6.71), sex (female: 5.85; male: 5.66), duration of diabetes (<\u200910 years: 6.15;\u2009≥\u200910 years: 4.85), weight (<\u200970 kg: 6.19;\u2009≥\u200970 kg: 5.39), BMI (<\u200925 kg/m2: 5.92;\u2009≥\u200925 kg/m2: 5.61), HbA1c (<\u20098.5%: 6.82;\u2009≥\u20098.5%: 4.08), triglycerides (<\u20092.3 mmol/L: 4.94;\u2009≥\u20092.3 mmol/L: 8.04), and concomitant OAMs (metformin: 5.68; sulfonylurea: 5.44; metformin plus sulfonylurea: 5.87). Similar results were observed for total amylase and lipase. In Chinese patients with T2DM receiving dulaglutide 1.5 mg in AWARD-CHN2, elevations of pancreatic enzymes over 26 weeks were within the normal range and were neither associated with pancreatitis nor baseline factors, which suggests the clinical use of dulaglutide in Chinese patients with T2DM is not associated with pancreatic safety issues. NCT01648582.