Lixisenatide Combination Therapy Outperforms Single Treatment Option for T2D

SEPTEMBER 12, 2017
Matt Hoffman
Juan Frias, Sanofi, Lixisenatide, EASD, DiabetesThe combination insulin glargine and lixisenatide injection (100 units/mL and 33 mcg/mL) provided earlier blood sugar control to more adults with type 2 diabetes (T2D) compared to insulin glargine 100 units/mL alone.

The Sanofi-produced injection, commercially known as Soliqua, allowed more patients to reach target hemoglobin A1C (HbA1c) levels at 8 and 12 weeks compared to the single solution injection, according to a posthoc analysis that was presented at the European Association for the Study of Diabetes (EASD) 53rd annual meeting in Lisbon, Portugal.

"Reaching an HbA1c target quickly can have a benefit for adults with type 2 diabetes," Juan Frias (pictured), MD, the president and principal investigator of the National Research Institute in Los Angeles, California, said in a statement. "Early, effective glycemic control can lead to better outcomes, both clinically and in terms of the overall cost of care."

The analysis examined 2 phase III trials, LixiLan-O and LixiLan-L, both of which compared the combination therapy with insulin glargine 100 units/mL on top of (if previously administered) metformin in almost 2000 adults with T2D (LixiLan-O n= 1170; LixiLan-L n=736). The trials examined blood glucose levels at 8 and 12 weeks and utilized the Kaplan-Meier method to estimate time to control.

In the LixiLan-O trial, 186 (39.7%) of the 469 patients in the combination arm reached target HbA1c levels, compared to 128 (27.5%) of the 467 in the single therapy arm. At 12 weeks, the combination therapy outperformed insulin glargine alone with 279 (59.6%) patients reaching target, compared to 209 (44.8%) (HR 1.5 [1.3, 1.7], CI 95%; p<0.0001)

In LixiLan-L, 116 (31.7%) of 365 patients reached control at 8 weeks in the combination arm, compared to 73 (20%) in the single therapy arm. When compared at 12 weeks, 168 (45.9%) in the combination arm reached target compared to 87 (23.8%) (HR 2.0 [1.7,2.5], CI 95%; p<0.0001).

The median time for 50% of patients to achieve HbA1c levels less than 7% in LixiLan-O was 85 days in the combination arm, compared to 166 days in the single therapy arm. In the LixiLan-L trial, 50% of the combination therapy arm achieved Hb1Ac less than 7% at 153 days, while the single-therapy arm never achieved the endpoint.

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