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Effects of lixisenatide versus liraglutide (short- and long-acting GLP-1 receptor agonists) on esophageal and gastric function in patients with type 2 diabetes

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posted on 09.07.2020 by Daniel R. Quast, Nina Schenker, Björn A. Menge, Michael A. Nauck, Christoph Kapitza, Juris J. Meier
Objective

Short-acting GLP-1 receptor agonists (GLP-1 RAs) decelerate gastric emptying more than long-acting GLP-1 RAs. Delayed gastric emptying is a risk factor for gastroesophageal reflux disease. We aimed to measure esophageal reflux and function as well as gastric emptying and acid secretion during treatment with short- (lixisenatide) and long-acting (liraglutide) GLP-1 RAs.

Research Design and Methods

57 subjects with type 2 diabetes were randomized to a 10-week treatment with lixisenatide or liraglutide. Changes from baseline in the number of reflux episodes during 24-hour pH registration in the lower esophagus, lower esophagus sphincter pressure, gastric emptying (13C-sodium octanoate acid breath test) and gastric acid secretion (13C-calcium carbonate breath test) were analyzed.

Results

Gastric emptying half-time was delayed by 52 min (16, 88) min with lixisenatide (p = 0.0065) and by 25 min (3, 46) with liraglutide (p = 0.025). There was no difference in the number of reflux episodes (33.7±4.1 vs. 40.1±5.3, p = 0.17) or the extent of gastroesophageal reflux (DeMeester-Score) (35.1±6.7 vs. 39.7±7.5, p = 0.61) with similar results for the individual GLP-1 RAs. No significant changes from baseline in other parameters of esophageal motility and lower esophageal sphincter function were observed. Gastric acidity decreased significantly by -20.7 (-40.6, -0.8) % (p = 0.042) with the GLP-1 RAs.

Conclusions

Lixisenatide exerted a more pronounced influence on gastric emptying after breakfast than liraglutide. Neither lixisenatide, nor liraglutide had significant effects on esophageal reflux or motility. Gastric acid secretion appears to be slightly reduced by GLP-1 RAs.



Funding

This study was sponsored by Novo Nordisk. The study sponsor was not involved in the design of the study, the collection, analysis, and interpretation of data, drafting the report, or the decision to submit the report for publication.

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