Division of Systems Medicine, School of Medicine, University of Dundee, Dundee, UK.
Al Hada Military Hospital, Taif, Saudi Arabia.
Diabetes Obes Metab. 2021 Jun;23(6):1221-1231. doi: 10.1111/dom.14354. Epub 2021 Apr 29.
Premix insulin is commonly used in some regions of the world, despite the higher risk of hypoglycaemia and weight gain compared with basal insulin, based on the premise that it offers a simplified insulin regimen. iGlarLixi is a once-daily titratable fixed-ratio formulation that combines basal insulin glargine 100 units/mL (iGlar) and the GLP-1 RA, lixisenatide, which offers a single-injection option for treatment intensification, with improved HbA1c reductions, similar hypoglycaemia risk and more favourable bodyweight profiles over iGlar alone. This randomized controlled study directly compares, for the first time, treatment intensification with iGlarLixi versus premix insulin analogue biphasic insulin aspart 30 (BIAsp 30) in adults with T2D inadequately controlled on basal insulin in combination with one or two oral antihyperglycaemic drugs.
This was an open-label, active-controlled, comparative, parallel-group, multicentre, phase 3b study. In total, 887 adults with T2D uncontrolled on basal insulin were randomized to switch to either iGlarLixi once daily, or BIAsp 30 twice daily, for 26 weeks.
Overall, 887 participants were enrolled (mean age 59.8 years, 50.2% female) from 89 centres in 17 countries. At baseline, 65.6% had a duration of T2D of 10 years or longer, and the mean HbA1c at baseline was 8.6%.
The study directly compared the efficacy and safety of iGlarLixi versus BIAsp 30 in people with T2D uncontrolled on basal insulin and one or more oral antihyperglycaemic agents. These results provide robust clinical data that may inform clinicians in their therapeutic management of people with T2D uncontrolled on basal insulin requiring additional therapy.
尽管与基础胰岛素相比,预混胰岛素低血糖和体重增加的风险更高,但基于其提供简化胰岛素治疗方案的前提,在世界上一些地区仍广泛使用预混胰岛素。iGlarLixi 是一种每日一次可滴定的固定比例配方,结合了基础胰岛素甘精 100 单位/毫升(iGlar)和 GLP-1RA 利西那肽,为治疗强化提供了一种单一注射选择,可降低 HbA1c,低血糖风险相似,且体重状况较单独使用 iGlar 更为有利。这项随机对照研究首次直接比较了 iGlarLixi 与预混胰岛素类似物双相门冬胰岛素 30(BIAsp 30)在基础胰岛素联合一种或两种口服降糖药治疗控制不佳的 T2D 成人中的治疗强化效果。
这是一项开放标签、活性对照、比较、平行组、多中心、3b 期研究。共有 887 名基础胰岛素控制不佳的 T2D 成人患者被随机分为两组,分别接受每日一次 iGlarLixi 或每日两次 BIAsp 30 治疗,疗程为 26 周。
共有 887 名参与者(平均年龄 59.8 岁,50.2%为女性)来自 17 个国家的 89 个中心。基线时,65.6%的患者 T2D 病程长达 10 年或更长,基线时的平均 HbA1c 为 8.6%。
该研究直接比较了 iGlarLixi 与 BIAsp 30 在基础胰岛素和一种或多种口服降糖药控制不佳的 T2D 患者中的疗效和安全性。这些结果提供了有力的临床数据,可能为临床医生治疗需要额外治疗的基础胰岛素控制不佳的 T2D 患者提供参考。