Visual Abstract
Introduction: No head-to-head trials compare iGlarLixi, a fixed-ratio combination of basal insulin (BI) and glucagon-like peptide-1 receptor agonist, with IDegAsp, a co-formulation of BI analog and meal-time insulin.
Methods: A systematic literature search of randomized controlled trials (RCTs) of iGlarLixi and IDegAsp vs. comparators was carried out. Studies were compared by an ITC using a Bayesian framework. Results are given for all trials, Japanese trials, and international trials.
Results: Eight RCTs (duration 24-30 weeks) were included. Change in HbA1c with iGlarLixi was greater, and bodyweight trajectory was more favorable than with IDegAsp for all analyses (Figure). A greater percentage of people achieved HbA1c target (<7.0 % [<53 mmol/mol]) with iGlarLixi in all trials (odds ratio [95% credible interval] 2.50 [1.06, 5.56]) and Japanese trials (2.17 [1.27, 3.70]), but was not confirmed in international trials (2.17 [0.42, 11.11]). Exploratory analysis suggested favorable differences in change in pre-meal self-measured plasma glucose (SMPG; all trials and international trials) and post-meal SMPG (all analyses) with iGlarLixi vs. IDegAsp. Hypoglycemia comparisons were inconclusive due to different definitions.
Conclusion: iGlarLixi offers clinical benefit in glycemic control and weight change vs. IDegAsp in those requiring both basal plus meal-time insulin interventions.
P. Home: Consultant; Self; American Diabetes Association, Kriya Technologies, Sanofi, Other Relationship; Self; Association of British Clinical Diabetologists, AstraZeneca, Novartis Malaysia, Sanofi, Research Support; Self; Sanofi. R. Mehta: Advisory Panel; Self; AstraZeneca, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Novo Nordisk, Sanofi, Speaker’s Bureau; Self; Abbott, Amgen Inc., Boehringer Ingelheim Pharmaceuticals, Inc. K. Hafidh: None. O. Gurova: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk, Sanofi, STADA, Takeda Pharmaceutical Co. A. Alvarez: Employee; Self; Sanofi. P. Serafini: Other Relationship; Self; Sanofi. M. Pourrahmat: Other Relationship; Self; Sanofi.
Sanofi