ADA 2020 — Once-weekly basal insulin icodec comparable to once-daily insulin glargine U100


  • Antara Ghosh
  • Conference Reports
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Takeaway

  • Once-weekly basal insulin analog icodec had comparable glucose-lowering effects and safety to once-daily insulin glargine U100 in inadequately controlled, insulin-naive patients with type 2 diabetes (T2D).

Why this matters

  • Once-weekly regimen would improve adherence than daily dosing.

Study design

  • This phase 2, double-blind trial evaluated 247 insulin-naive patients (mean age, 59.6 years) with T2D inadequately controlled with metformin±dipeptidyl peptidase 4 inhibitor.
  • Patients were randomly allocated to either weekly insulin icodec+daily placebo (n=125) or daily insulin glargine U100+weekly placebo (n=122).
  • Primary endpoint was change in glycated hemoglobin (A1c) from baseline to week 26.
  • Funding: None disclosed.

Key results

  • Change in A1c from baseline to week 26 dropped 1.33 vs 1.15 percentage points with icodec vs glargine (P=.08).
  • Proportions of patients achieving A1c
  • Drop in fasting plasma glucose was nearly identical for icodec vs glargine (58 mg/dL vs 54 mg/dL; P=.34).
  • The 9-point self-monitoring of blood glucose profile was significantly in favor of icodec (P=.01).
  • Hypoglycemia was more common with icodec vs glargine:
    • mild (53.6% vs 37.7%);
    • moderate or clinically significant (16.0% vs 9.8%); and
    • severe (1 vs 0 participants).
  • Weight gain (P=.88) and rates of other adverse events were similar.

Limitations

  • Small study population.

Expert commentary

Julio Rosenstock, MD, at University of Texas Southwestern Medical Center, Dallas, said: “I'm truly excited about the potential of such innovative treatments which could reduce the number of basal insulin injections for my patients with diabetes.”