NICE guidance - prolonged release exenatide
Last reviewed 01/2018
Prolonged-release exenatide in triple therapy regimens (that is, in combination with metformin and a sulphonylurea, or metformin and a thiazolidinedione) is recommended as a treatment option for people with type 2 diabetes when
- control of blood glucose remains or becomes inadequate (HbA1c >= 7.5%
[59 mmol/mol] or other higher level agreed with the individual), and the person
has:
- a body mass index (BMI) >= 35 kg/m2 in those of European family origin
(with appropriate adjustment for other ethnic groups) and specific psychological
or medical problems associated with high body weight or
- a BMI < 35 kg/m2, and therapy with insulin would have significant occupational implications or weight loss would benefit other significant obesity-related comorbidities.
- a body mass index (BMI) >= 35 kg/m2 in those of European family origin
(with appropriate adjustment for other ethnic groups) and specific psychological
or medical problems associated with high body weight or
Treatment with prolonged-release exenatide in a triple therapy regimen should only be continued if a beneficial metabolic response has been shown (defined as a reduction of at least 1 percentage point in HbA1c [11 mmol/mol] and a weight loss of at least 3% of initial body weight at 6 months).
Prolonged-release exenatide in dual therapy regimens (that is, in combination with metformin or a sulphonylurea) is recommended as a treatment option for people with type 2 diabetes, as described in only if:
- the person is intolerant of either metformin or a sulphonylurea, or a treatment with metformin or a sulphonylurea is contraindicated,
- and the person is intolerant of thiazolidinediones and dipeptidyl peptidase-4 (DPP-4) inhibitors, or a treatment with thiazolidinediones and DPP-4 inhibitors is contraindicated
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