Diabetes: add-on insulin degludec/liraglutide superior to insulin glargine

  • Philis-Tsimikas A & al.
  • Diabetes Obes Metab
  • 13 Feb 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Add-on insulin degludec/liraglutide to sodium-glucose cotransporter-2 inhibitor was superior and non-inferior to insulin glargine in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Why this matters

  • Previous cost-effectiveness analysis showed lower cost of treatment with insulin degludec/liraglutide per patient.

Study design

  • DUAL IX trial: 26-week, phase 3b, open-label, parallel-group, multinational, treat-to-target trial.
  • 210 insulin-naïve patients with uncontrolled T2DM were randomly assigned to add-on insulin degludec/liraglutide or insulin glargine to sodium-glucose cotransporter-2 inhibitor therapy.
  • Primary endpoint: change in HbA1c.
  • Funding: Novo Nordisk.

Key results

  • Insulin degludec/liraglutide was non-inferior to insulin glargine in terms of mean HbA1c reduction (1.9 vs 1.7% points; P<.0001 superiority was also confirmed in hba1c change points ci to>
  • Insulin degludec/liraglutide was also superior in terms for:
    • body weight (mean difference, −1.92 kg; 95% CI, −2.64 to −1.19);
    • severe or blood-glucose-confirmed symptomatic hypoglycaemia (rate ratio, 0.42; 95% CI, 0.23-0.75) and
    • total daily insulin dose (mean difference, −15.37 units; 95% CI, −19.60 to −11.13).
  • Treatment-emergent adverse event rate was 61.7% with insulin degludec/liraglutide and 58.6% with insulin glargine.
  • Insulin degludec/liraglutide treatment increased lipase levels and nausea incidence.

Limitations

  • Open-label design.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit