Once-daily prandial lixisenatide versus once-daily rapid-acting insulin in patients with type 2 diabetes mellitus insufficiently controlled with basal insulin: analysis of data from five randomized, controlled trials.

Abstract

AIMS:

To compare the efficacy and safety of lixisenatide (LIXI), a once-daily prandial glucagon-like peptide-1 (GLP-1) receptor agonist, as add-on to basal insulin (Basal+LIXI) versus once-daily rapid-acting insulin (Basal+RAI) in patients with type 2 diabetes mellitus (T2DM).

METHODS:

Data were extracted from five randomized controlled trials assessing the efficacy and safety of basal insulin+insulin glulisine (n=3) or basal insulin+LIXI (n=2). Patients in the Basal+LIXI cohort were matched to patients in the Basal+RAI cohort using propensity score matching.

RESULTS:

In the matched population, Basal+LIXI was twice as likely to reach composite outcomes of glycated haemoglobin (HbA1c) <7% and no symptomatic hypoglycaemia compared with the Basal+RAI group (odds ratio [OR]: 1.90; 95% confidence interval [CI]: 1.01, 3.55; P=0.0455), as well as HbA1c <7% and no severe hypoglycaemia (OR: 1.97; 95 CI: 1.06, 3.66; P=0.0311). Furthermore, Basal+LIXI was more than twice as likely to reach HbA1c <7%, no weight gain and no symptomatic hypoglycaemia (OR: 2.58; 95% CI: 1.23, 5.40; P=0.0119).

CONCLUSIONS:

Both basal+LIXI and Basal+RAI improved glycaemic control in patients with T2DM with inadequate glycaemic control on basal insulin. Basal+LIXI offers an effective therapeutic option to advance basal insulin therapy, improving glucose control without weight gain and with less risk of hypoglycaemia than prandial insulin.

• Authors: Denis Raccah, Jay Lin, Edward Wang, Maeva Germé, Riccardo Perfetti, Riccardo C Bonadonna, Pedro de Pablos-Velasco, Ronan Roussel, Julio Rosenstock
• Journal: Journal of diabetes and its complications (J Diabetes Complications) 2014 Jan-Feb Vol. 28 Issue 1 Pg. 40-4 ISSN: 1873-460X [Electronic] United States
• PMID: 24246441 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2013.

Chemical References

• Glycated Hemoglobin A
• Insulin, Long-Acting
• Insulin, Short-Acting
• Peptides
• hemoglobin A1c protein, human
• Insulin Detemir
• lixisenatide

Topics

• Aged
• Case-Control Studies
• Diabetes Mellitus, Type 2 (blood, drug therapy, epidemiology)
• Drug Administration Schedule
• Female
• Glycated Hemoglobin (metabolism)
• Humans
• Insulin Detemir
• Insulin, Long-Acting (therapeutic use)
• Insulin, Short-Acting (administration & dosage)
• Male
• Meals
• Middle Aged
• Peptides (administration & dosage)
• Randomized Controlled Trials as Topic
• Treatment Failure