EFFICACY AND SAFETY OF IDEGLIRA IN OLDER PATIENTS WITH TYPE 2 DIABETES.

Abstract

OBJECTIVE:

The efficacy and safety of insulin degludec/liraglutide (IDegLira) in older patients has not yet been reported. This analysis aimed to evaluate the efficacy and safety of IDegLira in patients aged ≥65 years.

METHODS:

A post hoc analysis compared results of patients aged ≥65 versus <65 years from DUAL II, III, and V. These were 26-week, phase 3, randomized, twoarm parallel, treat-to-target trials in patients already taking injectable glucose-lowering agents. We evaluated 311 patients aged <65 and 87 patients aged ≥65 years from DUAL II, 326 patients <65 years and 112 patients ≥65 years from DUAL III, and 412 patients <65 years and 145 patients ≥65 years from DUAL V. Patients were randomized to IDegLira or insulin degludec (DUAL II), IDegLira or unchanged glucagon-like peptide 1-receptor agonist (GLP-1RA) (DUAL III), or IDegLira or IGlar U100 (DUAL V).

RESULTS:

In patients ≥65 years, hemoglobin A1C decreased to a greater extent with IDegLira than with comparators (estimated treatment differences, -1.0% [-1.5; -0.6]95% confidence interval [CI], -0.8% [-1.0; -0.5]95% CI, and -0.9% [-1.3; -0.6]95%CI) for DUAL II, V, and III, respectively; all P<.001). These mirrored results of patients <65 years of age. Hypoglycemia rates were lower with IDegLira versus basal insulin and higher versus unchanged GLP-1RA (estimated rate ratios, 0.5 [0.2; 1.6]95% CI [ P = .242]; 0.3 [0.1; 0.5]95% CI [ P<.001], and 11.8 [3.3; 42.8]95% CI [ P<.001] for DUAL II, V, and III, respectively).

CONCLUSION:

Patients aged ≥65 years on basal insulin or GLP-1RA can improve glycemic control with IDegLira, and it is well tolerated overall.

ABBREVIATIONS:

A1C = hemoglobin A1C; AE = adverse event; CI = confidence interval; Degludec = insulin degludec; EOT = end of trial; ETD = estimated treatment difference; FPG = fasting plasma glucose; GLP-1RA = glucagon-like peptide 1 receptor agonist; IDegLira = insulin degludec/liraglutide; IGlar U100 = insulin glargine 100 U/mL; SU = sulfonylurea; T2D = type 2 diabetes.

• Authors: Ildiko Lingvay, Yehuda Handelsman, Sultan Linjawi, Tina Vilsbøll, Natalie Halladin, Kristina Ranc, Andreas Liebl
• Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (Endocr Pract) Vol. 25 Issue 2 Pg. 144-155 (Feb 2019) ISSN: 1530-891X [Print] United States
• PMID: 30383495 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Blood Glucose
• Drug Combinations
• Glycated Hemoglobin A
• Hypoglycemic Agents
• IDegLira
• Insulin, Long-Acting
• Insulin Glargine
• Liraglutide

Topics

• Aged
• Blood Glucose
• Diabetes Mellitus, Type 2 (drug therapy)
• Drug Combinations
• Glycated Hemoglobin
• Humans
• Hypoglycemic Agents
• Insulin Glargine
• Insulin, Long-Acting (therapeutic use)
• Liraglutide (therapeutic use)