Effects of IDegLira (Insulin Degludec/Liraglutide) in Patients with Poorly Controlled Type 2 Diabetes (T2D) with A1C >9%—Analyses from the DUAL Program

Abstract

Despite a variety of treatment options for type 2 diabetes (T2D), more than half of patients do not achieve glycemic control. In a post-hoc analysis of the DUAL I (oral antidiabetic drugs [OADs]), II, V and VII (basal insulin + OADs) trials, we evaluated patients with an A1C >9% at baseline to determine the impact of IDegLira on their glycemic control. Within each DUAL trial, baseline characteristics for patients with A1C >9% were similar for all treatment groups. In DUAL I, II and V, treatment with IDegLira resulted in greater reductions in A1C from baseline, vs. comparators of basal insulin or liraglutide, leading to lower A1C at end of trial (EOT). In DUAL VII, reduction in A1C from baseline and A1C at EOT were comparable for IDegLira and insulin glargine U100 (100 U/mL) + insulin aspart (≤4 times/day). At EOT, the composite endpoint of A1C <7% without hypoglycemia (DUAL I, II and V: unable to self-treat and/or plasma glucose [PG] <56 mg/dL; DUAL VII: unable to self-treat or PG <56 mg/dL with hypoglycemia symptoms) was achieved by a greater proportion of patients treated with IDegLira than with comparators. In conclusion, even in patients with T2D with A1C >9%, IDegLira treatment achieved glycemic control with a high proportion of patients achieving A1C <7% and clinically important composite endpoints of A1C <7% without hypoglycemia and/or weight gain. Disclosure D. Sugimoto: Research Support; Self; Novo Nordisk A/S. J.P. Frias: Research Support; Self; AbbVie Inc., Allergan, Amgen Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company. Consultant; Self; CeQur Corporation. Research Support; Self; Cirius Therapeutics, AstraZeneca, Calibra Medical, Elcelyx Therapeutics, Inc.. Consultant; Self; Elcelyx Therapeutics, Inc.. Research Support; Self; Eli Lilly and Company, Genentech, Inc., Ionis Pharmaceuticals, Inc., ICON plc., Janssen Pharmaceuticals, Inc.. Consultant; Self; Johnson & Johnson Diabetes Institute, LLC.. Research Support; Self; Lexicon Pharmaceuticals, Inc., Ligand Pharmaceuticals, Inc.. Consultant; Self; Ligand Pharmaceuticals, Inc.. Research Support; Self; Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Pfizer Inc., Sanofi. Consultant; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; Theracos, Inc. D. Gouet: Research Support; Self; Novo Nordisk A/S, Eli Lilly and Company, Boehringer Ingelheim GmbH, Medtronic, Johnson & Johnson Diabetes Institute, LLC., Sanofi. R. Takács: None. T. Jia: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. P. örsy: Employee; Self; Novo Nordisk A/S. S.C. Bain: Research Support; Self; Novo Nordisk Inc., AstraZeneca.