Despite increasing awareness and new developments in the treatment and prevention of diabetes, there has been a rapid increase in the number of people with T2D.²
Tight glycemic control may reduce the risk of diabetes complications in people with T2D.³

Non-adherence to treatment is a barrier to effective care. Only 50% adherence to long-term therapy exists among patients with chronic diseases in developed* countries.4

The magnitude and impact of poor adherence in developing countries is assumed to be even higher

Additionally, clinical inertia can be encountered at any step in T2D management and can delay appropriate treatment intensification for both oral anti-diabetic agents and injectable therapy.5

AWARD: A clinical trial programme spanning the continuum of care

AWARD 3(6) Dulaglutide vs metformin
Drug-naive or washout from 1 OAM
AWARD 5(7) Dulaglutide vs sitagliptin
Add-on to metformin
AWARD 6(1) Dulaglutide vs liraglutide
Add-on to metformin
AWARD 8(8) Dulaglutide vs placebo
Add-on to glimepiride
AWARD 1(9) Dulaglutide vs exenatide
Add-on to metformin and pioglitazone
AWARD 2(10) Dulaglutide vs insulin glargine
Add-on to metformin and glimepiride
AWARD 10(11) Dulaglutide vs placebo
Add-on to SGLT2 inhibitors with or without metformin
AWARD 4(12) Dulaglutide vs insulin glargine
Both with mealtime insulin lispro with or without metformin
AWARD 9(13) Dulaglutide vs placebo with insulin glargine
with or without metformin
AWARD 7(14) Dulaglutide vs insulin glargine
Add-on to prandial lispro
AWARD-6 Trial Summary
Research Design and Method
HbA1c=glycated haemoglobin; QW=once a week; QD=once a day; BMI=body mass index. *Table adapted from Dungan KM, et al. Lancet. 2014;348(9951): 1349−1357.
Results
Primary endpoint met: non-inferiority of dulaglutide 1.5 mg vs liraglutide 1.8 mg in HbA1c reduction from baseline to 26 weeks (-1.42% vs -1.36%, P<0.0001 for non-inferiority)
HbA1c=glycated haemoglobin *Graph adapted from Dungan KM, et al. Lancet. 2014;348(9951): 1349−1357
Nausea, diarrhoea, dyspepsia, and vomiting were the most common GI adverse events in all patients.
Similar rates of hypoglycemia were observed in both treatment groups.
Conclusions
Findings from the AWARD-6 study lend support to the efficacy of the GLP-1 receptor agonist drugs, dulaglutide and liraglutide, for control of hyperglycemia in T2D. With once-weekly dulaglutide 1.5 mg, patients administered substantially fewer injections and yet still achieved similar glycemic benefits. Long-term, once-weekly drugs might improve compliance compared with more frequently administered regimens, but this notion will require further assessment.
References:
1. Dungan KM, et al. Lancet. 2014;384: 1349−1357.
2. International Diabetes Federation. IDF Diabetes Atlas, 8th ed. Brussels, Belgium: International Diabetes Federation, 2017.
3. Stratton IM, et al. BMJ. 2000;321(7258): 405−412
4. World Health Organization. Adherence to long-term therapies – evidence for action. 2003 WHO website. http://apps.who.int/medicinedocs/en/d/Js4883e/6.html. Accessed 7 November 2017.
5. Khunti S, et al. British Journal of Diabetes and Vascular Disease. 2015;15(2): 65−69.
6. Umpierrez G, et al. Diabetes Care. 2014;37: 2168−2176.
7. Nauck M, et al. Diabetes Care. 2014;37: 2149−2158.
8. Dungan KM, et al. Diabetes, Obesity and Metabolism. 2016;18: 475−482.
9. Wysham C, et al. Diabetes Care. 2014;37: 2159−2167.
10. Giorgino F, et al. Diabetes Care. 2015;38: 2241−2249.
11. Ludvik B, et al. Lancet Diabetes & Endocrinology. 2018;6: 370−381.
12. Blonde L, et al. Lancet. 2015;385: 2057−2066.
13. Pozzilli P, et al. Diabetes, Obesity and Metabolism. 2017;19: 1024−1031.
14. Tuttle KR, et al. Lancet Diabetes & Endocrinology. 2018;6: 605−617.

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