EASD 2020 — Once-weekly insulin icodec shows promise in phase 2


  • Deepa Koli
  • Conference Reports
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Takeaway

  • Once-weekly treatment with insulin icodec showed glucose-lowering efficacy and a safety profile similar to that of once-daily insulin glargine in patients with type 2 diabetes.

Why this matters

  • Once-weekly insulin can significantly reduce the number of injections from 365 to 52 per year.

Study design

  • A 26-week, randomised, double-blind, double-dummy, treat-to-target, active-controlled, parallel-group, multinational phase 2 trial.
  • 247 patients with type 2 diabetes who had not previously received long-term insulin treatment were randomly assigned 1:1 to receive once-weekly insulin icodec or once-daily insulin glargine.
  • The primary endpoint was the change in the glycated haemoglobin (HbA1C) level from baseline to week 26. 
  • Funding: Novo Nordisk.

Key results

  • Mean HbA1C at baseline and at week 26 were:
    • Icodec group: 8.1% and 6.7%, respectively.
    • Glargine group: 8.0% and 6.9%, respectively.
  • The estimated mean change in HbA1C from baseline was not significantly different between 2 groups (estimated mean difference [EMD], −0.18%; P=.08).
  • No difference was observed in the estimated mean fasting plasma glucose at week 26 between the groups (EMD, −0.22 [95% CI, −0.66 to 0.23] mmol/L).
  • The estimated mean weekly insulin dose during the last 2 weeks of treatment was significantly lower with icodec vs glargine (229 vs 284 Units/week)
    • Estimated treatment ratio, 0.81 (95% CI, 0.69-0.94).
  • The observed rates of combined level 2 and 3 hypoglycaemia were similar for icodec vs glargine (53 vs 46 events per 100 patient-years of exposure; P=.85).
  • No new safety signals were reported.

Limitations

  • Limited power to detect significant differences between treatments for any endpoint.