Glycaemic target attainment in people with Type 2 diabetes treated with insulin glargine/lixisenatide fixed‐ratio combination: a post hoc analysis of the LixiLan‐O and LixiLan‐L trials. Issue 2 (26th November 2019)

• Record Type: Journal Article
• Authors: Davidson, J. A.; Desouza, C.; Fonseca, V.; Frias, J. P.; Van Gaal, L.; Giorgino, F.; Chao, J.; Dex, T. A.; Roberts, M.; Saremi, A.; Leiter, L. A.
• Is Part Of: Diabetic medicine. Volume 37:Issue 2(2020)
• Page Start: 256
• Page End: 266
• Publication Date: 2019-11-26
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.14094
• Languages: English
• ISSNs: 0742-3071

Abstract

What's new?: Achievement of both fasting (FPG) and postprandial plasma glucose (PPG) targets is important for optimal glycaemic control in Type 2 diabetes. This post hoc analysis of the LixiLan‐O and LixiLan‐L trials shows that targeting both FPG and PPG results in improved glycaemic control, with weight neutrality and a low risk of hypoglycaemia. It is clinically desirable to achieve control of FPG and PPG. More people treated with iGlarLixi achieved control, and those who did so reached an HbA1c target of < 53 mmol/mol (< 7.0%), had a greater drop in HbA1c, and did not gain weight compared with insulin glargine or lixisenatide alone. Abstract: Aims: Both fasting (FPG) and postprandial plasma glucose (PPG) contribute to HbA1c levels. We investigated the relationship between achievement of American Diabetes Association (ADA) and American Association of Clinical Endocrinologists (AACE) recommended FPG and/or PPG targets and glycaemic efficacy outcomes in two trials. Methods: In this post hoc analysis, data from participants with Type 2 diabetes in the phase 3 LixiLan‐O (NCT 02058147) and LixiLan‐L (NCT 02058160) trials were evaluated to compare the relationship between achievement of society‐recommended FPG and/or PPG targets and efficacy (HbA1c change, HbA1c goal attainment, weight change) and safety outcomes in the treatment groups. Results: Across treatment arms, iGlarLixi achieved the highest proportion of participants meeting both ADA‐ and AACE‐recommended FPG and PPG targets at study end in both trials. A higher proportion of participants in the iGlarLixi (fixed‐ratio combination of insulin glargine and lixisenatide) vs. insulin glargine alone or lixisenatide alone treatment arms achieved HbA1c goals ( P < 0.001 for overall comparisons), irrespective of ADA‐ or AACE‐defined targets. Hypoglycaemia rates [any, documented symptomatic (plasma glucose ≤ 3.9 mmol/l), and clinically important (plasma glucose < 3.0 mmol/l)] were low across all groups. Participants treated with iGlarLixi tended to show weight loss or less weight gain compared with participants receiving insulin glargine alone. No differences were observed in average daily basal insulin dose at week 30 between the two treatment arms or across the different FPG and PPG target groups. Conclusion: Insulin glargine and lixisenatide as a fixed‐ratio combination resulted in more participants reaching both FPG and PPG targets, leading to better HbA1c target attainment.