iGlarLixi reduces residual hyperglycemia in Japanese patients with type 2 diabetes uncontrolled on basal insulin: A post‐hoc analysis of the LixiLan JP‐L trial

Abstract

Introduction Treatments for type 2 diabetes targeting baseline glucose levels but not postprandial glucose can result in normalized fasting blood glucose but suboptimal overall glycemic control (high glycated hemoglobin): residual hyperglycemia. In Japanese patients with type 2 diabetes the predominant pathophysiology is a lower insulin secretory capacity, and residual hyperglycemia is common with basal insulin treatment. Single‐injection, fixed‐ratio combinations of glucagon‐like peptide‐1 receptor agonists and basal insulin have been developed. iGlarLixi (insulin glargine 100 units/mL [iGlar]: lixisenatide ratio of 1 unit:1 µg) is for specific use in Japan. Post‐hoc analysis of the LixiLan JP‐L trial (NCT02752412) compared the effect of iGlarLixi with iGlar on this specific subpopulation with residual hyperglycemia. Materials and Methods Outcomes at week 26 (based on the last observation carried forward) were assessed in patients in the modified intent‐to‐treat population with baseline residual hyperglycemia. Results Overall, 83 (32.5%) patients in the iGlarLixi group and 79 (30.7%) patients in the iGlar group had baseline residual hyperglycemia. The proportion of patients with residual hyperglycemia at week 26 decreased to 15.7% in the iGlarLixi group, and increased to 36.9% in the iGlar group. Patients in the iGlarLixi group had significantly greater reductions in glycated hemoglobin compared with the iGlar group (−0.72% difference between groups; P < 0.0001). Conclusions New data from this post‐hoc analysis of the JP‐L trial show that treatment with the fixed‐ratio combination iGlarLixi reduced the proportion of Japanese patients with residual hyperglycemia from baseline to week 26 and significantly reduced glycated hemoglobin vs similar doses of iGlar alone.

Benefit of insulin glargine/lixisenatide for reducing residual hyperglycaemia in Japan: Post hoc analysis of the LixiLan JP‐O2 trial

“…The results of the JP‐O2 trial are similar to those of the JP‐L trial, 7 , 10 although the magnitude of the iGlarLixi‐associated decrease in residual hyperglycaemia was greater in the JP‐L than in the JP‐O2 trial, perhaps reflecting the higher proportion of participants with residual hyperglycaemia at baseline in the JP‐L trial. 7 Taken together, these data suggest that treatment intensification with iGlarLixi is probable to achieve better glycaemic control, with less residual hyperglycaemia, than iGlar alone in Japanese people with treated, but uncontrolled, T2D.…”

“… 9 Similarly, in a comparable trial conducted in Japanese people with T2D (LixiLan JP‐L), the proportion with residual hyperglycaemia after 26 weeks was 15.7% with iGlarLixi and 36.9% with iGlar; the difference between the treatment arms was statistically significant (21.1%; 95% confidence interval: 13.7%, 28.5%; P < .0001). 10 …”

Advances in insulin therapy from discovery to β‐cell replacement

“…To date, there are two once daily FRCs of basal insulin and GLP‐1RA on the market (iGlarLixi and iDegLira); once weekly FRC is under development. Accumulating evidence suggests that iGlarLixi and iDegLira are especially effective in Asian patients with type 2 diabetes 14 , 15 , 16 .…”