What are the indications for Liraglutide (Glucagon-like peptide-1 (GLP-1) receptor agonist)?

Indications for Liraglutide

Liraglutide is indicated as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus, and to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus and established cardiovascular disease. 1

Primary Indications

Type 2 Diabetes Management

• Approved for use in adults and children ≥10 years old with type 2 diabetes 1
• Functions as a glucagon-like peptide-1 (GLP-1) receptor agonist that:
  • Increases insulin secretion in a glucose-dependent manner
  • Inhibits glucagon secretion
  • Delays gastric emptying
  • Reduces appetite 2
• Provides significant glycemic control with A1C reductions of 0.8-1.5% 3
• Can be used as:
  • Monotherapy when metformin is contraindicated or not tolerated
  • Combination therapy with other antidiabetic medications (metformin, sulfonylureas, thiazolidinediones, or basal insulin) 2, 3

Cardiovascular Risk Reduction

• Specifically indicated to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease 1
• In the LEADER trial, liraglutide demonstrated a 13-26% reduction in major adverse cardiovascular events in patients with type 2 diabetes and high cardiovascular risk 2

Special Populations and Considerations

Pediatric Use

• Approved for children ≥10 years old with type 2 diabetes 2, 1
• In pediatric patients, liraglutide should be considered if glycemic targets are not met with metformin, and if there is no personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 2

Weight Management Benefits

• Associated with weight loss of approximately 2-4% of initial body weight 3
• Particularly beneficial for overweight or obese patients with type 2 diabetes 3

Patients with NAFLD/NASH

• May provide benefit in patients with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) 2
• Has been shown to reduce liver fat content and transaminases in people with type 2 diabetes and NAFLD 2

Dosing Information

• Starting dose: 0.6 mg subcutaneously once daily for one week
• Maintenance dose: Can be increased to 1.2 mg daily, and further to 1.8 mg daily if needed for glycemic control 2
• Gradual dose titration helps minimize gastrointestinal side effects 2

Important Limitations and Contraindications

• Not indicated for treatment of type 1 diabetes mellitus 1
• Should not be coadministered with other liraglutide-containing products 1
• Contraindicated in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 2

Common Adverse Effects

• Gastrointestinal effects (nausea, vomiting, diarrhea) are most common but typically transient 3, 4
• Low risk of hypoglycemia when used as monotherapy 4
• Nausea can be minimized with appropriate dose titration 3

Liraglutide represents an important treatment option for type 2 diabetes management with the added benefits of weight reduction, low hypoglycemia risk, and cardiovascular protection for patients with established cardiovascular disease.