Fixed-Ratio Combination of Insulin and GLP-1 RA in Patients with Longstanding Type 2 Diabetes: A Subanalysis of LixiLan-L Article

Full Text via DOI: 10.1007/s13300-020-00797-y PMID: 32166620 Web of Science: 000524361900022
Open Access Industry Collaboration International Collaboration

Cited authors

  • Blonde, Lawrence; Berard, Lori; Saremi, Aramesh; Huang, Yao; Aroda, Vanita R.; Raccah, Denis

Abstract

  • Introduction With longer duration and progression of type 2 diabetes (T2D), beta-cell function deteriorates and insulin therapy often becomes necessary. Glucagon-like peptide-1 receptor agonists such as lixisenatide that do not rely only on beta-cell function and glucagon suppression primarily, but also lower glucose by other (insulin-independent) mechanisms such as delayed gastric emptying, may be appropriate adjuvant therapy to basal insulin in patients with longstanding T2D. Methods We assessed the efficacy and safety of insulin glargine (iGlar) versus iGlarLixi, a fixed-ratio combination of iGlar and lixisenatide, stratified by quartiles (Q) of T2D duration (<= 7.305 [Q1], > 7.305 to <= 10.75 [Q2], > 10.75 to <= 15.67 [Q3], and > 15.67 years [Q4]) in the LixiLan-L trial (N = 736). Results Across all quartiles, the reduction in glycated haemoglobin was greater with iGlarLixi versus iGlar, and the difference was most pronounced in patients with the longest duration (Q4; least squares mean difference [standard error] - 0.62 [0.13], P < 0.0001). Additionally, hypoglycaemia rates were significantly lower with iGlarLixi versus iGlar in patients in Q4 (3.3 vs. 6.9 events/patient-year, P < 0.0001). Conclusion iGlarLixi lowered glycated haemoglobin more versus iGlar regardless of T2D duration, with benefit retained even among patients with the longest T2D duration.

Publication date

  • 2020

Published in

International Standard Serial Number (ISSN)

  • 1869-6953

Start page

  • 1007

End page

  • 1015

Volume

  • 11

Issue

  • 4