850-P: Greater HbA1c Reduction with iGlarLixi vs. Insulin Glargine and Lixisenatide Regardless of Levels at Screening: Subgroup Analysis of the LixiLan-O Asia Pacific Trial

Introduction: LixiLan-O-AP (NCT03798054) showed greater HbA_1c improvement with iGlarLixi vs. iGlar or Lixi in Asian Pacific adults with type 2 diabetes (T2D) . This pre-defined analysis assessed iGlarLixi efficacy by HbA_1c levels at screening.

Methods: Adults (N=878) with suboptimally controlled T2D (HbA_1c of 7.5-% or 7-% depending on background oral antihyperglycemic drug [OAD] use) on metformin ± a second OAD were randomized 2:2:1 to iGlarLixi, iGlar or Lixi for 24 weeks. Three screening HbA_1c subgroups were defined: <8, 8-<9, ≥9 %.

Results: At Week 24, in all HbA_1c subgroups, iGlarLixi was associated with greater HbA_1c reductions vs. iGlar or Lixi and reached mean HbA_1c levels <7 %. iGlarLixi also showed greater 2-h postprandial glucose reductions, and a higher proportion of participants reaching HbA_1c <7 % and HbA_1c <7 % without weight gain, vs. iGlar or Lixi (Table) . Incidence and rates of documented hypoglycemia ≤70 mg/dL (≤3.9 mmol/L) were similar between iGlarLixi and iGlar in the 8-<9 % and ≥9 % subgroups but were slightly higher with iGlarLixi vs. iGlar in the <8 % subgroup.

Conclusions: Regardless of HbA _1c level at screening, iGlarLixi demonstrated better glycemic control vs. iGlar or Lixi, with over 75% of participants achieving the recommended target HbA _1c (<7 %) with iGlarLixi, even those with HbA_1c ≥9 % at screening.

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