- 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.
- 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.
- 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.
- Small study population.
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.”