Amylin Pharmaceuticals, Inc., and Eli Lilly and Company announced that the US Food and Drug Administration (FDA) has approved an expanded indication for Byetta (exenatide) injection. Byetta is now approved for use as a stand-alone medication (monotherapy) along with diet and exercise to improve glycemic control in adults with type 2 diabetes. Previously, it was approved for use only in patients who were also taking other common diabetes medications and had not achieved adequate glycemic control.

"The expanded indication gives physicians the option to prescribe Byetta as a first-line treatment, increasing the number of patients who may benefit from the medication and providing an opportunity to treat patients with Byetta earlier in the disease," said Orville G Kolterman, M.D., senior vice president of research and development, Amylin Pharmaceuticals. "Type 2 diabetes is a complex disease, so it is essential that healthcare professionals and their patients have a wide array of treatments that can effectively control blood glucose levels."

The approval of Byetta as a monotherapy treatment was based on a clinical study of patients with type 2 diabetes who were unable to achieve glycemic control through diet and exercise alone. Study findings showed that patients treated with 5 mcg or 10 mcg of Byetta as monotherapy reduced their A1C, a measure of average blood sugar over three months, by 0.7 percentage points and 0.9 percentage points, respectively, and lost 6.0 pounds and 6.4 pounds, respectively. Results of this study were published in Clinical Therapeutics in August 2008.

Among treatment-emergent adverse events, nausea was reported with the greatest incidence (5 mcg, 3 per cent; 10 mcg, 13 per cent). Hypoglycaemia was reported in 5 per cent of patients taking 5 mcg and 4 per cent of patients taking 10 mcg, with no severe hypoglycaemic events.

In addition to the monotherapy indication, the FDA approved changes to the Byetta Prescribing Information to incorporate updated safety information, including pancreatitis-related language added to the Warnings and Precautions section. This update addresses the alert issued by the FDA in August 2008. The new label also expands upon existing language regarding use of Byetta in patients with renal impairment. In addition, the label has been amended to match the format the FDA currently uses for Prescribing Information.

"Patient safety is our foremost concern at Amylin and Lilly, and the Byetta Prescribing Information represents an important way to communicate the information that healthcare professionals and patients need in order to use the medication safely and effectively," Kolterman continued. "Thus, the updated label offers the most current information about the benefit-risk profile of Byetta as a foundational therapeutic choice for people with type 2 diabetes."

Byetta has been used by more than one million patients since market introduction in 2005. It has a proven history with more than 10 million prescriptions written and 6.5 years of clinical experience.

Byetta is the first and only FDA-approved GLP-1 receptor agonist for the treatment of type 2 diabetes. Byetta exhibits many of the same effects as the human incretin hormone glucagon-like peptide-1 (GLP-1). GLP-1 improves blood sugar after food intake through multiple effects that work in concert on the stomach, liver, pancreas and brain.

Byetta is an injectable prescription medicine that may improve blood sugar (glucose) control in adults with type 2 diabetes mellitus, when used with a diet and exercise programme. Byetta is not insulin and should not be taken instead of insulin. Byetta is not recommended to be taken with insulin. Byetta is not for people with type 1 diabetes or people with diabetic ketoacidosis.

Byetta provides sustained A1C control and low incidence of hypoglycaemia when used alone or in combination with metformin or a thiazolidinedione, with potential weight loss. Byetta is not a weight loss product. Byetta was approved in April 2005 and has been used by more than one million patients since its introduction.