Results and Comparisons from the RISE Clinical Trial—Adult Medication Study
Presented by:
David A. Ehrmann, MD
The University of Chicago, Chicago, IL, USA Kieren J. Mater, MD
Indiana University School of Medicine, Indianapolis, IN, USA Sharon Edelstein, ScM
George Washington University, Washington, DC, USA Steven E. Khan, MD, ChB
VA Puget Sound Health Care System, Seattle, WA, USA Thomas A. Buchanan, MD
University of Southern California, Los Angeles, CA, USA Sonia Caprio, MD
Yale University School of Medicine, New Haven, CT, USA
Prior research has demonstrated that interventions targeting improvements in b-cell function and/or insulin sensitivity can be effective in slowing or reversing progressive loss of glycemic control. The Restoring Insulin Secretion (RISE) Adult Medication Study asked the question of whether β-cell function be preserved or improved during 12 months of pharmacologic intervention, and maintained for 3 months following the withdrawal of therapy, in adults with impaired glucose tolerance (IGT) or recently diagnosed type 2 diabetes.
RISE compared pharmacological approaches targeted to improve ß-cell function in individuals with IGT or treatment-naive type 2 diabetes of <12 months duration.
All three active treatments produced on-treatment reductions in weight and improvements in HbA1c compared with placebo, with the greatest reductions in the liraglutide plus metformin group.
At 12 months, glucose-stimulated C-peptide responses improved in the three active treatment groups and were greatest in the liraglutide plus metformin group, but the arginine-stimulated incremental C-peptide response was reduced in the liraglutide plus metformin group.
Despite on-treatment benefits, 3 months after treatment withdrawal there were no sustained improvements in ß-cell function in any treatment group.
In adults with IGT or recently diagnosed type 2 diabetes, interventions that improved ß-cell function during active treatment failed to produce persistent benefits after treatment withdrawal.
Key Messages/Clinical Perspectives
Continued intervention may be required to alter progressive ß-cell dysfunction in IGT or early type 2 diabetes.
The RISE Consortium. Lack of Durable Improvements in β-Cell Function Following Withdrawal of Pharmacological Interventions in Adults With Impaired Glucose Tolerance or Recently Diagnosed Type 2 Diabetes. Diabetes Care. 2019 Jun;dc190556.
Present disclosure: D.A. Ehrmann, S. Edelstein, S. Caprio: the presenters has reported that no relationships exist relevant to the contents of this presentation. K.J. Mater: Roche, Abbott, Merch & Co. Inc., Novo Nordisk A/S, Sanofi. K.E. Khan: Boehringer Ingelheim, Eli Lilly, Intarcia, Janssen, Merck & Co., Novo Nordisk A/S, Neurimmune. T.A. Buchanan: Allergan, Apollo EndoSurgery.
Jose C. Florez, MD, PhD
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