779-P: Intensification of Glucagon-Like Peptide-1 Receptor Agonists Therapy with First and Second Generation Basal Insulins—The RESTORE-G Real-World Study

Abstract

ADA guidelines suggest that in patients needing insulin treatment, combination therapy with a glucagon-like peptide 1 receptor agonist (GLP1-RA) is recommended for greater efficacy, durability of treatment effect, and weight and hypoglycemia benefit. However, when treatment with GLP1-RA needs to be intensified, switch to insulin approach is still very common. It is also known that second generation basal insulins (2BI) provide similar or improved efficacy with a better safety profile compared to first generation basal insulins (1BI). Aim of this RESTORE-G sub-study was to perform a propensity-score adjusted comparative effectiveness analysis of adding-on/switching to 2BI vs. 1BI in patients on GLP1-RA therapy (±oral hypoglycemic agents) needing intensification. Table shows sample sizes, patients characteristics and effectiveness results. Data shows that 2BI vs. 1BI was associated with significantly larger improvements in HbA1c and FBG both in add-on and switch approaches. In the switch approach, 2BI produced lower weight gain versus 1BI. Switching vs. adding on was associated with a more frequent use of short acting insulin. Both 1BI and 2BI were poorly titrated. Disclosure R.Napoli: Advisory Panel; Sanofi, Eli Lilly and Company, Novo Nordisk, Research Support; Novo Nordisk, AstraZeneca, Speaker's Bureau; Sanofi, Eli Lilly and Company, Novo Nordisk, AstraZeneca, MSD Life Science Foundation. M.Larosa: None. A.Nicolucci: Board Member; AstraZeneca, Research Support; Novo Nordisk, Sanofi, Sobi, Shionogi & Co., Ltd., AlfaSigma, Speaker's Bureau; Boehringer Ingelheim and Eli Lilly Alliance. M.Rossi: Research Support; Sanofi, Novo Nordisk, Shionogi & Co., Ltd., AlfaSigma. R.Candido: None. Restore-g study group: n/a. Funding Sanofi