2303-PUB: Efficacy of Dulaglutide (DU) as First Injectable Option for Patients with Type 2 Diabetes (T2D): A Post Hoc Pooled Analysis

Abstract

Background: ADA-EASD consensus report recommends using GLP-1RAs including DU as 1st injectable therapy prior to basal insulin in most patients with T2D not at their glycemic goals after oral antidiabetic medications (OADs). Objective To assess the glycemic efficacy of DU 1.5 mg in patients with T2D when added on background of commonly used OAD regimens. Methods: Patients from 7 Phase-3 trials where DU 1.5 mg was added to OADs were pooled and categorized based on OAD regimens into the following categories; Metformin (MET), sulfonylurea (SU), MET + SU, MET + Pioglitazone, MET + SGLT2i. DU 0.75 mg was assessed in only 5 studies and hence not included in this analysis. Change from baseline in HbA1c, fasting serum glucose and body weight, % patients with HbA1c <7%, GI adverse events and hypoglycemia were assessed. Results: Table 1 summarizes the glycemic and weight outcomes of DU at baseline and after 6 months for different OAD categories. HbA1c reduction of -1.3 to -1.6% and weight change of -0.8 to -2.9 kg was seen when DU was added to different OADs. Nausea, vomiting and diarrhea were reported by 10-35%, 4-19% and 6-28% patients respectively. Severe hypoglycemia occurred in 1 patient in MET+SU group. Conclusion: In patients with T2D on different OAD regimens and requiring an additional glycemic control, DU demonstrated clinically meaningful glycemic control making it an effective first injectable option. Disclosure H. Patel: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. K.M. Munir: None. S.S. Sutherland: Other Relationship; Self; Eli Lilly and Company. M. Konig: Employee; Self; Eli Lilly and Company, Eli Lilly and Company.