Impact of Type 2 Diabetes (T2D) Duration on Response to iGlarLixi vs. IGlar—A Subanalysis of LixiLan-L

Abstract

Shorter-acting GLP-1RA like lixisenatide have insulin-independent effects, which may benefit patients (pts) with longer T2D duration and more β-cell dysfunction. We assessed the effects of insulin glargine (iGlar) vs. fixed-ratio iGlar plus lixisenatide (iGlarLixi) by T2D duration in the LixiLan-L trial (N=736). HbA1c, weight, insulin dose change (BL-Wk 30) and hypoglycemia were analyzed in pts divided in quartiles by recorded baseline (BL) T2D duration (<7.3; 7.3-<10.7; 10.7-15.7; >15.7 years). Pts were also grouped by BL insulin dose (may relate inversely to β-cell function). BL HbA1c was higher in long-duration quartiles but similar with iGlarLixi vs. iGlar. iGlarLixi reduced HbA1c more vs. iGlar across duration quartiles (Figure). Difference was greater in pts in the longest duration quartile (LS mean difference [SE] -0.62 [0.13]; p<0.0001). In both treatment groups, pts in the shortest duration quartile had the greatest insulin dose change (BL-Wk 30). Difference in hypoglycemia (iGlarLixi vs. iGlar) was greatest in pts in the longest duration quartile (3.3 vs. 6.9 events/pt-yr; p<0.0001). In pts grouped by T2D duration and insulin dose, those with both long duration (>15.7 years) and high dose (>42 U) showed greatest difference in HbA1c lowering with iGlarLixi vs. iGlar. In LixiLan-L, iGlarLixi lowered HbA1c more vs. iGlar regardless of T2D duration, with greatest difference in those with longest duration. Disclosure L. Blonde: Other Relationship; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Advisory Panel; Self; Intarcia Therapeutics, Inc.. Other Relationship; Self; Lexicon Pharmaceuticals, Inc.. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Other Relationship; Self; Janssen Scientific Affairs, LLC.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Merck & Co., Inc., Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Other Relationship; Self; Novo Nordisk Inc., Sanofi. Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi US. L. Berard: Other Relationship; Self; Abbott, Becton, Dickinson and Company, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Sanofi, Montmed Inc., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., LifeScan Canada. Consultant; Self; Ascensia Diabetes Care. Other Relationship; Self; Novo Nordisk Inc., Merck & Co., Inc. A. Saremi: Employee; Self; Sanofi US. Y. Huang: Consultant; Self; Sanofi. V. Aroda: Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc., AstraZeneca, Calibra Medical, Eisai Inc., Sanofi. Consultant; Self; Sanofi. Research Support; Self; Theracos, Inc.. Employee; Spouse/Partner; Merck & Co., Inc.. Other Relationship; Self; American Diabetes Association. Consultant; Self; ADOCIA. D. Raccah: Advisory Panel; Self; Novo Nordisk Inc., Lilly, Sanofi, Merck & Co., Inc..