Liraglutide in adjunctive therapy in type 1 diabetes: tolerability and discontinuation — summary of findings
Outcome-by-outcome summary with effect, certainty and the reason for each downgrade.
Templated review frame. This review question was generated by crossing an indication with a compound for which contributing trials exist. Its prose frame is templated and is shared with other questions of the same shape. Its included studies, its summary of findings and its certainty rating are computed from the underlying records and are not templated. The Institute publishes these questions because the alternative is to leave a question the document set can answer unanswered, and it labels them because the alternative is to present a templated frame as an authored one.
§4Summary of findings
§4.1Summary of findings
Table 7. Summary of findings for Liraglutide in adjunctive therapy in type 1 diabetes: tolerability and discontinuation.
| Outcome | Participants (studies) | Effect as reported | Certainty | Reason for downgrade |
|---|---|---|---|---|
| Change in HbA1cThe outcome the Institute designates as anchor for this indication. | 2,233 (2) | Modest glycaemic improvement with increased hypoglycaemia and hyperglycaemia with ketosis; the Institute reports the composite as… | Moderate | imprecision |
| Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission. | 2,029 (2) | Reported per contributing trial; see the included-studies table | Moderate | publication bias |
| Serious adverse eventsEvent counts are low; the estimate is imprecise by construction. | 1,931 (2) | Reported per contributing trial; see the included-studies table | Low | risk of bias, indirectness |
| Any adverse eventAscertained by spontaneous report in the contributing trials. | 1,823 (2) | Reported per contributing trial; see the included-studies table | Low | inconsistency |
| Change in total daily insulin doseA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 1,015 (1) | Reported as a secondary outcome in a subset of contributing trials | Low | inconsistency, indirectness |
| Time in range on continuous glucose monitoringA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 1,235 (1) | Reported as a secondary outcome in a subset of contributing trials | Low | risk of bias, indirectness |
| Certainty ratings describe confidence in the effect estimate for the stated outcome. They are not recommendations and do not transfer between outcomes. | ||||
§4.2Forest plot
§4.3Certainty assessment for the anchor outcome
Table 8. Reasoning recorded against each certainty domain for the anchor outcome.
| Domain | Rating | Reasoning |
|---|---|---|
| Risk of bias | No concern | No serious concern identified in this domain. |
| Inconsistency | No concern | No serious concern identified in this domain. |
| Indirectness | No concern | No serious concern identified in this domain. |
| Imprecision | Serious | A single small trial contributes the whole estimate. |
| Publication bias | No concern | No serious concern identified in this domain. |
| Overall: Moderate certainty. The true effect is likely to be close to the estimate, but there is a possibility that it is substantially different. Further research is likely to have an important impact on confidence in the estimate. | ||
References cited on this page
References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.
- Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DCW, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JPH. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. New England Journal of Medicine 2015;373(1):11–22. doi:10.1056/NEJMoa1411892 · PMID 26132939
- Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JFE, Nauck MA, Nissen SE, Pocock S, Poulter NR, Ravn LS, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Buse JB. Liraglutide and cardiovascular outcomes in type 2 diabetes. New England Journal of Medicine 2016;375(4):311–322. doi:10.1056/NEJMoa1603827 · PMID 27295427
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