Initiation of iGlarLixi Versus Basal-Bolus Insulin in Adults With Type 2 Diabetes Advancing From Basal Insulin Therapy: The SoliComplex Real-World Study.

Background

When type 2 diabetes is suboptimally controlled with basal insulin, prandial insulin injections are commonly added (i.e., a basal-bolus insulin regimen), which can increase treatment burden and hypoglycemia risk. The once-daily injectable iGlarLixi is an alternative treatment.

Methods

This retrospective analysis of the U.S. Optum Clinformatics database compared outcomes in adults (≥18 years of age) with type 2 diabetes who previously received basal insulin and were newly initiated on iGlarLixi or basal-bolus insulin therapy. Cohorts were propensity score-matched in a 1:1 ratio on baseline characteristics, and imbalances were adjusted in multivariate analyses. Subgroup analyses were performed for people ≥65 years of age and those with a baseline A1C ≥9%. The primary end point was persistence with therapy at 12 months in the overall population. Secondary end points were treatment adherence, health care resource utilization (HCRU), costs, any hypoglycemia, and A1C change at 12 months.

Results

Cohorts each comprised 1,070 participants. Treatment persistence at 12 months was statistically significantly higher for iGlarLixi versus basal-bolus insulin therapy (43.7 vs. 22.3%, hazard ratio 0.51, 95% CI 0.46-0.57, adjusted

Conclusion

In this observational study, initiation of once-daily iGlarLixi versus basal-bolus insulin was associated with higher persistence, lower hypoglycemia, and similar A1C reduction without increasing HCRU or costs regardless of age or A1C. iGlarLixi could be an alternative to basal-bolus insulin, particularly for older adults with type 2 diabetes who require treatment simplification with lower hypoglycemia risk.

Informations de copyright

© 2023 by the American Diabetes Association.

Déclaration de conflit d'intérêts

K.M.P. has been on speakers’ bureaus for AstraZeneca, Corcept Therapeutics, Merck, and Novo Nordisk; has been a consultant to AstraZeneca, Bayer, Corcept Therapeutics, Diasome, Eli Lilly Company, Merck, Novo Nordisk, Sanofi, and Twinhealth; and has received research support from Bayer, Merck, Novo Nordisk, and Twinhealth. C.H. is an employee of Aetion, a contractor paid by Sanofi for this project. R.L. has been on speakers’ bureaus for AstraZeneca, Boehringer Ingelheim, Eli Lilly Company, Novo Nordisk, Sanofi, and Zealand and been a consultant to AstraZeneca, Eli Lilly Company, and Novo Nordisk. E.L., X.L, and T.D. are employees of Sanofi and may hold shares and/or stock options in the company. C.R.K. has been on speakers’ bureaus for Abbott, Amgen, Dexcom, Novo Nordisk, and Sanofi.