Letters to the Editor

I would like to bring to your attention an issue related to the new drug comment on dulaglutide for type 2 diabetes.1

The conclusion, under the heading ‘Place in therapy’, states that ‘Dulaglutide appears to have a greater effect on HbA1c than exenatide’. The reference given is the AWARD-1 trial, which to date is the only head-to-head study comparing the efficacy and safety of dulaglutide with placebo and exenatide.2 However, in this trial the comparator was exenatide 10 microgram twice daily (not the once-weekly formulation of exenatide).

The article in its current form may mislead physicians to believe that dulaglutide was demonstrated to be superior to the two available formulations of exenatide. To accurately reflect the current evidence, the comment should have said that dulaglutide appears to have a greater effect on HbA1c than exenatide 10 microgram twice daily. At present there is no evidence indicating greater efficacy of dulaglutide versus exenatide once weekly.

Alessandra Sandrini
Associate medical director
Cardiovascular Renal and Metabolism, AstraZeneca, Sydney


The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by any responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

Alessandra Sandrini

Associate medical director, Cardiovascular Renal and Metabolism, AstraZeneca, Sydney