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Effectiveness of insulin degludec/liraglutide versus insulin degludec/insulin aspart in Japanese patients with type 2 diabetes

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Abstract

Aims

To evaluate and compare the effectiveness of once-daily insulin degludec/liraglutide (IDegLira) to that of once-daily insulin degludec/insulin aspart (IDegAsp) after switching from basal insulin therapy at 6 months by assessing changes in hemoglobin A1c (HbA1c), body weight, and insulin doses in patients with type 2 diabetes (T2D).

Materials and methods

A total of 91 patients with T2D with HbA1c levels exceeding 7.0% were included in this study. Adjusted least square mean changes in HbA1c, body weight, and total insulin doses were compared between the IDegLira group and IDegAsp group. Subgroup analyses were performed, stratified by median values of HbA1c (< 8.5 and ≥ 8.5%), obesity (body mass index < 25 and ≥ 25 kg/m2), and basal insulin doses (< 14 and ≥ 14 units) at baseline to assess treatment interaction by subgroup.

Results

The IDegLira group showed a greater reduction in HbA1c levels than the IDegAsp group (− 0.17 vs − 0.79%, p = 0.003) with comparable body weight changes. The analyses of adjusted mean changes of total insulin doses showed that the IDegAsp group had a larger increase than the IDegLira group (3.64 vs 1.30 unis, p = 0.016). The effect of IDegLira on HbA1c levels was superior to that of IDegAsp in patients with high HbA1c. There were no inter-group differences in the rate of hypoglycemic episodes.

Conclusions

Once-daily IDegLira had greater effects on HbA1c and a lesser increase in insulin doses than IDegAsp when patients are switched from basal insulin therapy. Moreover, the effect on HbA1c was enhanced in patients with high HbA1c levels at baseline.

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Data availability

All data generated or analyzed during this study are included in this published article. The data are not publicly available due to ethical restrictions. However, the datasets are available from the corresponding author on reasonable request.

References

  1. American Diabetes Association Professional Practice Committee. 9. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes- 2022. Diabetes Care. 2022;45:S125–43.

  2. Roussel R, Charbonnel B, Behar M, et al. Persistence with insulin therapy in patients with type 2 diabetes in France: an insurance claims study. Diabetes Ther. 2016;7:537–49.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Chan JC, Malik V, Jia W, et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301:2129–40.

    Article  CAS  PubMed  Google Scholar 

  4. Onishi Y, Ono Y, Rabol R, et al. Superior glycaemic control with once-daily insulin degludec/insulin aspart versus insulin glargine in Japanese adults with type 2 diabetes inadequately controlled with oral drugs: controlled phase 3 trial. Diabetes Obes Metab. 2013;15:826–32.

    Article  CAS  PubMed  Google Scholar 

  5. Hughes E. IDegLira: redefining insulin optimization using a single injection in patients with type 2 diabetes. Prim Care diabetes. 2016;10:202–9.

    Article  PubMed  Google Scholar 

  6. Novo Nordisk. Xultophy summary of product characteristics. 2022. https://www.medicines.Org.uk/emc/medicine/29493. Accessed 1 Sept 2022.

  7. Watada H, Kaneko S, Komatsu M, et al. Superior HbA1c control with the fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with a maximum dose of 50 units of insulin degludec in Japanese individuals with type 2 diabetes in a phase 3, double-blind, randomized trial. Diabetes Obes Metab. 2019;21:2694–703.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Billings LK, Doshi A, Gouet D, et al. Efficacy and safety of IDegLira versus basal-bolus insulin therapy in patients with type 2 diabetes uncontrolled on metformin and basal insulin: the DUAL VII randomized clinical trial. Diabetes Care. 2018;41:1009–16.

    Article  CAS  PubMed  Google Scholar 

  9. Price H, Blüher M, Prager R, et al. Use and effectiveness of a fixed-ratio combination of insulin degludec/ liraglutide (IDegLira) in a real-world population with type 2 diabetes: results from a European, multicentre, retrospective chart review study. Diabetes Obes Metab. 2018;20:954–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Egede LE, Bogdanov A, Fischer L, et al. Glycemic control among patients newly prescribed IDegLira across prior therapy group in US real-world practice. Diabetes Ther. 2020;11:1579–89.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Little RR, Rohlfing CL, Wiedmeyer HM, et al. The national glycohemoglobin standardization program: a five-year progress report. Clin Chem. 2001;47:1985–92.

    CAS  PubMed  Google Scholar 

  12. Castellana M, Cignarelli A, Brescia F, et al. GLP-1 receptor agonist added to insulin versus basal-plus or basal-bolus insulin therapy in type 2 diabetes: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2019;35: e3082.

    Article  PubMed  Google Scholar 

  13. Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001;23:1296–310.

    Article  CAS  PubMed  Google Scholar 

  14. Melzer-Cohen C, Chodick G, Naftelberg S, et al. Metabolic control and adherence to therapy in type 2 diabetes mellitus patients using IDegLira in a real-world setting. Diabetes Ther. 2020;11:185–96.

    Article  CAS  PubMed  Google Scholar 

  15. Shigiyama F, Liu L, Nordahl H, et al. A real-world prospective, non-interventional study of adults with T2D switching to IDegAsp from glargine U100 or U300 in Japan. Diabetes Ther. 2021;12:2405–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Kawaguchi Y, Miyamoto S, Hajika Y, et al. Efficacy of IDegLira versus IDegAsp therapy in patients with type 2 diabetes: a randomized crossover study by isCGM. Adv Ther. 2022;39:2688–700.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Watada H, Anger BFR, Doshi A, et al. IDegLira improves glycemic control in Japanese patients with uncontrolled type 2 diabetes on premixed insulin therapy. Diabetes Ther. 2020;11:331–9.

    Article  CAS  PubMed  Google Scholar 

  18. Mori Y, Taniguchi Y, Sezaki K, et al. Liraglutide narrows the range of circadian glycemic variations in Japanese type 2 diabetes patients and nearly flattens these variations in drug-naïve type 2 diabetes patients: a continuous glucose monitoring-based study. Diabetes Technol Ther. 2011;13:1139–44.

    Article  CAS  PubMed  Google Scholar 

  19. Mathieu C, Rodbard HW, Cariou B, et al. A comparison of adding liraglutide versus a single daily dose of insulin aspart to insulindegludec in subjects with type 2 diabetes (BEGIN: Victoza ADD-ON). Diabetes Obes Metab. 2014;16:636–44.

    Article  CAS  PubMed  Google Scholar 

  20. Jammah AA. Indirect comparison of efficacy and safety of insulin glargine/lixisenatide and insulin degludec/ insulin aspart in type 2 diabetes patients not controlled on basal insulin. Prim Care Diabetes. 2021;15:132–7.

    Article  CAS  PubMed  Google Scholar 

  21. Drucker DJ. Mechanisms of action and therapeutic application of glucagon-like peptidE-1. Cell Metab. 2018;27:740–56.

    Article  CAS  PubMed  Google Scholar 

  22. Kozawa J, Inoue K, Iwamoto R, et al. Liraglutide is effective in type 2 diabetic patients with sustained endogenous insulin-secreting capacity. J Diabetes Investig. 2012;3:294–7.

    Article  CAS  PubMed  Google Scholar 

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Junko Oya, Tomoko Nakagami, Yukiko Hasegawa, Yuichiro Kondo, Aki Katamine, Mika Shimizu, Ryo Kubota, Rika Suda & Tetsuya Babazono

Authors
  1. Junko Oya
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  2. Tomoko Nakagami
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  3. Yukiko Hasegawa
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  4. Yuichiro Kondo
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  5. Aki Katamine
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  6. Mika Shimizu
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  7. Ryo Kubota
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  8. Rika Suda
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  9. Tetsuya Babazono
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Contributions

J.O. contributed to the study design, data collection, data analysis, and the development of the manuscript. T.N., Y.H., A.K., M.S., R.K., R.S. and Y.K. contributed the study design, performed the statistical analysis, and the development of the manuscript. T.B. researched data, edited and reviewed the manuscript. All authors were involved in discussion about the results and in writing the manuscript and have approved this manuscript.

Corresponding author

Correspondence to Junko Oya.

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Conflict of interest

T Babazono has received honoraria for lectures from Eli Lilly Japan K.K., Nippon Boehringer Ingelheim Co. Ltd., Sanofi K.K., Novo Nordisk Pharma Ltd., Sumitomo Pharma Co. Ltd., Sanwa Kagaku Kenkyusyo Co. Ltd.; has received research support from Daiichi Sankyo Co. Ltd., Eli Lilly Japan K.K., Women’s Health Japan K.K.; and has received grants from Sanwa Kagaku Kenkyusyo Co. Ltd., Sumitomo Pharma Co. Ltd., Ono Pharmaceutical Co. Ltd., Chugai Pharmaceutical Co. Ltd., Abbott Japan LLC. T Nakagami reported personal fee from Sanwa Kagaku Kenkyusho Co Ltd, Novo Nordisk Pharma Ltd Japan, Eli Lily Japan KK, Sanofi K.K., Sumitomo Pharma, and Boehringer Ingelheim Japan Inc. Other authors declare that they have no conflict interest.

Ethical standard

The study was approved by the Ethics Review Committee of Tokyo Women’s Medical University (Approval no. 2481-R3, November 18, 2022). All clinical investigations were conducted in accordance with the tenets of the Declaration of Helsinki.

Informed consent

Because of the retrospective observational design, written informed consent was not obtained from the participants, although it was obtained via the opt-out method through the website of the institution.

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Oya, J., Nakagami, T., Hasegawa, Y. et al. Effectiveness of insulin degludec/liraglutide versus insulin degludec/insulin aspart in Japanese patients with type 2 diabetes. Diabetol Int 15, 237–243 (2024). https://doi.org/10.1007/s13340-023-00681-7

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  • DOI: https://doi.org/10.1007/s13340-023-00681-7

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