Home Philip, Lauand Felipe, Djaballah Khier, Li Xuan-Tony, Hafidh Khadija, Mehta Roopa, Faraoun Khadra, Anaforoğlu İnan, Serafini Paul, Pourrahmat Mir-Masoud
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Sanofi, Paris, France.
Diabetes Obes Metab. 2025 Jun;27(6):3410-3418. doi: 10.1111/dom.16360. Epub 2025 Apr 2.
To estimate the relative treatment effect of iGlarLixi (a fixed-ratio combination of insulin glargine 100 U/mL plus lixisenatide) versus premixed insulin IDegAsp (insulin degludec plus insulin aspart) in people with type 2 diabetes (T2D) who advanced from basal insulin to iGlarLixi or IDegAsp in non-Asian studies.
Randomized controlled trials (RCTs) were identified in a systematic review by searching Embase (including congress abstracts from 2021 to 2023), MEDLINE® and CENTRAL on 10 October 2023. Treatment outcomes from non-Asian RCTs for people with T2D previously treated with basal insulin, who switched to iGlarLixi or IDegAsp, were compared using a network meta-analysis (NMA). Data analysis was performed using R, version 4.0.2.
The NMA included four RCTs (N = 2535). The results of the NMA showed that iGlarLixi (n = 810) was associated with a significantly greater reduction in HbA1c versus IDegAsp (n = 454) (mean difference [MD]: -0.39 [95% credible interval, CrI: -0.58, -0.21] %-units). iGlarLixi was also associated with a significantly greater likelihood of achieving an HbA1c of <7.0% (risk ratio: 1.42, 95% CrI: 1.18, 1.71). A greater reduction in postprandial glucose was observed with iGlarLixi versus IDegAsp (MD: -1.38 [95% CrI: -2.15, -0.63] mmol/L). A body weight benefit that favoured iGlarLixi versus IDegAsp was documented (MD: -1.54 [95% CrI: -2.26, -0.84] kg). Hypoglycaemia evaluation was inconclusive due to definitional differences between trials.
Once-daily iGlarLixi was associated with superior blood glucose control and body weight benefit compared with IDegAsp in insulin-experienced populations with T2D in non-Asian RCTs.
在非亚洲研究中，评估甘精胰岛素利司那肽固定比例复方制剂（甘精胰岛素100U/mL加利司那肽）与预混胰岛素德谷门冬胰岛素（德谷胰岛素加门冬胰岛素）相比，对从基础胰岛素转换为甘精胰岛素利司那肽或德谷门冬胰岛素的2型糖尿病（T2D）患者的相对治疗效果。
于2023年10月10日通过检索Embase（包括2021年至2023年的会议摘要）、MEDLINE®和CENTRAL进行系统评价，以识别随机对照试验（RCT）。使用网状Meta分析（NMA）比较非亚洲RCT中既往接受基础胰岛素治疗、转而使用甘精胰岛素利司那肽或德谷门冬胰岛素的T2D患者的治疗结局。使用R 4.0.2版本进行数据分析。
NMA纳入了4项RCT（N = 2535）。NMA结果显示，与德谷门冬胰岛素（n = 454）相比，甘精胰岛素利司那肽（n = 810）与糖化血红蛋白（HbA1c）的显著更大降幅相关（平均差值[MD]：-0.39[95%可信区间，CrI：-0.58，-0.21]%-单位）。甘精胰岛素利司那肽还与HbA1c<7.0%的显著更高可能性相关（风险比：1.42，95%CrI：1.18，1.71）。与德谷门冬胰岛素相比，甘精胰岛素利司那肽使餐后血糖有更大降幅（MD：-1.38[95%CrI：-2.15，-0.63]mmol/L）。记录到与德谷门冬胰岛素相比，甘精胰岛素利司那肽有体重获益（MD：-1.54[95%CrI：-2.26，-0.84]kg）。由于各试验之间的定义差异，低血糖评估尚无定论。
在非亚洲RCT中，对于有胰岛素治疗经验的T2D人群，每日一次的甘精胰岛素利司那肽与德谷门冬胰岛素相比，血糖控制更佳且有体重获益。
