The Committee for Medicinal Products for Human Use (CHMP) issued a positive opinion for the use of Victoza (liraglutide) in adults with type 2 diabetes and moderate renal impairment. Once the European Commission approves the label expansion, physicians in the European Union will be able to prescribe Victoza, the once-daily human glucagon-like peptide-1 (GLP-1) analogue, to adults with type 2 diabetes and moderate renal impairment without dose adjustments.

Renal impairment is a challenging and common long-term complication of type 2 diabetes that requires frequent monitoring of blood glucose levels and kidney function. Depending on age, duration of diabetes and blood glucose control, up to 40 per cent of people with type 2 diabetes will develop some degree of renal impairment.

"Renal impairment is very common in patients with type 2 diabetes, and the choice of glucose-lowering therapies available to people with both conditions is limited", said Melanie Davies, professor of Diabetes Medicine and honorary consultant, Diabetes Research Centre, University of Leicester, UK and clinical trial investigator. "This label update gives physicians an additional treatment option to help their patients with type 2 diabetes and moderate renal impairment achieve glycaemic control."

The CHMP recommendation for Victoza was based on efficacy and safety data from the LIRA-RENAL phase 3b clinical trial.

The 26-week, double-blind, randomised, controlled study investigated the efficacy and safety of Victoza compared with placebo when added to pre-existing oral antidiabetic treatment, insulin or a combination thereof in adults with type 2 diabetes and moderate renal impairment.

The addition of once-daily Victoza versus placebo in adults with type 2 diabetes and moderate renal impairment showed statistically significantly greater reduction in mean HbA1c (-1.05 per cent vs. -0.38 per cent) and body weight (-2.41 kg vs -1.09 kg).

Adults treated with Victoza experienced no change in renal function (estimated glomerular filtration rate [eGFR] (Modification of Diet in Renal Disease [MDRD]) change from baseline: liraglutide -1 per cent; placebo +1 per cent).

There was a comparable risk of hypoglycaemic episodes between the two treatment groups. The safety profile of Victoza was generally similar to that observed in other studies of the treatment

Victoza (liraglutide) is a human glucagon-like peptide-1 (GLP-1) analogue with an amino acid sequence 97 per cent similar to endogenous human GLP-1. Like natural GLP-1, Victoza works by stimulating the beta cells to release insulin and suppressing glucagon secretion from the alpha cells only when blood sugar levels are high. Due to this glucose-dependent mechanism of action, Victoza is associated with a low rate of hypoglycaemia. In addition, Victoza reduces body weight and body fat mass through mechanisms involving reduced appetite and lowered food intake. Victoza is not approved for weight management or for use in people who do not have type 2 diabetes.

Victoza was launched in the EU in 2009 and is commercially available in more than 70 countries with more than 2.3 million patient years of exposure in people with type 2 diabetes globally. In Europe, Victoza is indicated for treatment of adults with type 2 diabetes to achieve glycaemic control in combination with oral glucose-lowering medicinal products and/or basal insulin when these, together with diet and exercise, do not provide adequate glycaemic control. In the US, Victoza was approved on 25 January 2010 as an adjunct to diet and exercise to improve blood glucose control in adults with type 2 diabetes.  Hypoglycaemia has primarily been observed when Victoza is combined with a sulfonylurea.