Po410 Efficacy and Safety of Liraglutide vs Placebo When Added to Basal Insulin Analogues in Subjects With Type 2 Diabetes (Lira-Add2basal): A Randomised, Placebo-Controlled Trial

Ahmann, Andrew; Rosenstock, J; Rodbard, Helena W.; Lahtela, Jorma; Loredo, Luis De; Tornøe, Karen; Wang, F.; Ma, Ning

doi:10.1016/s0168-8227(14)70704-1

Cited by 2 publications

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“…Seven phase III studies have investigated the addition of a GLP-1 RA in patients uncontrolled on basal insulin therapy ( Table 3) [51][52][53][54][55][56][57]. In four studies, the addition of the GLP-1 RA was compared with placebo, while three studies compared the addition of a GLP-1 RA to basal insulin intensification with one or three daily bolus insulin doses.…”

Section: Datamentioning

confidence: 99%

“…In summary, several phase III clinical trials have now shown that combining a GLP-1 RA with basal insulin results in a significant HbA 1c reduction, in some cases to well within target levels, while maintaining a low risk of hypoglycaemia and often with the added benefit of weight loss (Table 3) [45,46,[51][52][53][54][55][56]. In general, long-acting GLP-1 RAs appear to be the most potent at lowering HbA 1c and may be the best choice for patients who are not near their HbA 1c target after basal optimization.…”

Section: Datamentioning

confidence: 99%

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Role of incretin‐based therapies and sodium‐glucose co‐transporter‐2 inhibitors as adjuncts to insulin therapy in Type 2 diabetes, with special reference to IDegLira

Wilding

Bain

2015

Diabet. Med.

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The progressive nature of Type 2 diabetes necessitates treatment intensification over time in order to maintain glycaemic control, with many patients ultimately requiring insulin therapy. While insulin has unlimited potential efficacy, its initiation is often delayed and improvements in glycaemic control are typically accompanied by weight gain and an increased risk of hypoglycaemia, particularly as HbA1c approaches and falls below target levels. This may account for the sub-optimal control often achieved after insulin initiation. Combining insulin with antihyperglycaemic therapies that have a low risk of hypoglycaemia and are weight-neutral or result in weight loss is a therapeutic strategy with the potential to improve Type 2 diabetes management. Although the effects differ with each individual class of therapy, clinical trials have shown that adding a glucagon-like peptide-1 receptor agonist, dipeptidyl peptidase-4 inhibitor or sodium-glucose co-transporter-2 inhibitor to insulin regimens can offer a significant reduction in HbA1c without substantially increasing hypoglycaemia risk, or weight. The evidence and merit of each approach are reviewed in this paper. Once-daily co-formulations of a basal insulin and a glucagon-like peptide-1 receptor agonist have been developed (insulin degludec/liraglutide) or are under development (lixisenatide/insulin glargine). Insulin degludec/liraglutide phase III trials and a lixisenatide/insulin glargine phase II trial have shown robust HbA1c reductions, with weight loss and a low risk of hypoglycaemia. With insulin degludec/liraglutide now approved in Europe, an important consideration will be the types of patients who may benefit most from a fixed-ratio combination; this is discussed in the present review, and we also take a look toward future developments in the field.

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Section: Datamentioning

confidence: 99%

Section: Datamentioning

confidence: 99%

Role of incretin‐based therapies and sodium‐glucose co‐transporter‐2 inhibitors as adjuncts to insulin therapy in Type 2 diabetes, with special reference to IDegLira

Wilding

Bain

2015

Diabet. Med.

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Cost Effectiveness of Insulin Degludec Plus Liraglutide (IDegLira) in a Fixed Combination for Uncontrolled Type 2 Diabetes Mellitus in Sweden

Ericsson¹,

Lundqvist

2017

Appl Health Econ Health Policy

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BackgroundPatients with uncontrolled type 2 diabetes mellitus (T2DM) are a priority group for intensified therapy without weight gain and with low risk of hypoglycaemia.ObjectiveThis study evaluates the cost effectiveness of insulin degludec plus liraglutide (IDegLira, Xultophy®) compared with six potential intensification treatment options for patients with T2DM that is uncontrolled with basal insulin.MethodsThe Swedish Institute for Health Economics (IHE) Cohort Model of Type 2 Diabetes was used with Swedish input data, a 40-year time frame and a societal perspective. The comparators for treatment intensification included insulin glargine, neutral protamine Hagedorn (NPH) insulin, insulin aspart plus either glargine or NPH, and liraglutide plus either glargine or NPH. Clinical data for all comparators (except NPH insulin) were based on an indirect treatment comparison of several studies. Prices were obtained from the 2014 Swedish Dental and Pharmaceutical Benefits Agency (Tandvårds- och läkemedelsförmånsverket [TLV]) database, and utility values were obtained from published studies. Sensitivity analyses were undertaken.ResultsOverall incremental cost-effectiveness ratios (ICER) were Swedish krona (SEK) 70,000 or lower per quality-adjusted life-year (QALY). IDegLira compared with intensified basal insulin showed an ICER of SEK 28,000 per QALY versus insulin glargine, SEK70,000 per QALY versus NPH insulin and SEK 60,000 per QALY versus NPH insulin plus liraglutide. IDegLira was dominant over insulin glargine plus liraglutide and insulin aspart plus insulin glargine or NPH insulin. Results were driven by the difference in glycated haemoglobin (HbA1c) reduction between treatments, as confirmed by sensitivity analyses.ConclusionsIDegLira is estimated to be a cost-effective treatment in Sweden compared with commonly used intensification treatments for patients with T2DM uncontrolled with basal insulin.Electronic supplementary materialThe online version of this article (doi:10.1007/s40258-016-0301-y) contains supplementary material, which is available to authorized users.

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Po410 Efficacy and Safety of Liraglutide vs Placebo When Added to Basal Insulin Analogues in Subjects With Type 2 Diabetes (Lira-Add2basal): A Randomised, Placebo-Controlled Trial

Cited by 2 publications

References 0 publications

Role of incretin‐based therapies and sodium‐glucose co‐transporter‐2 inhibitors as adjuncts to insulin therapy in Type 2 diabetes, with special reference to IDegLira

Role of incretin‐based therapies and sodium‐glucose co‐transporter‐2 inhibitors as adjuncts to insulin therapy in Type 2 diabetes, with special reference to IDegLira

Cost Effectiveness of Insulin Degludec Plus Liraglutide (IDegLira) in a Fixed Combination for Uncontrolled Type 2 Diabetes Mellitus in Sweden

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