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Efficacy and safety of lixisenatide in a predominantly A sian population with type 2 diabetes insufficiently controlled with basal insulin: T he GetGoal‐L‐C randomized trial
Author(s) -
Yang Wenying,
Min Kyungwan,
Zhou Zhiguang,
Li Ling,
Xu XiangJin,
Zhu Dalong,
Venkateshwar Rao A.,
Murthy Laxminarayanappa Sreenivasa,
Zhang Nianxian,
Li Ivy,
Niemoeller Elisabeth,
Shang Shuhua
Publication year - 2018
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13072
Subject(s) - lixisenatide , postprandial , metformin , medicine , placebo , type 2 diabetes , randomized controlled trial , diabetes mellitus , adverse effect , insulin , clinical endpoint , endocrinology , gastroenterology , exenatide , alternative medicine , pathology
Aims To assess the effects on glycaemic control of lixisenatide vs placebo as add‐on treatment to basal insulin (BI) ± metformin and effects on glycated haemoglobin (HbA1c) reduction in patients with insufficiently controlled type 2 diabetes (T2D). Methods Patients (n = 448) with inadequately controlled T2D were randomized (1:1) to lixisenatide or placebo as add‐on to BI ± metformin for 24 weeks after an 8‐week run‐in phase, during which BI was titrated to a target self‐monitored plasma glucose (SMPG; 4.4‐5.6 mmol/L). The primary endpoint was absolute change in HbA1c from baseline to week 24. Secondary efficacy endpoints included: percentage of responders; changes in 2‐hour postprandial plasma glucose (PPG); 7‐point SMPG (daily average); body weight (BW); total daily BI dose; fasting plasma glucose; and safety assessments. Results Baseline demographics were similar in the two treatment groups. After insulin optimization during run‐in, lixisenatide was superior to placebo in mean change from baseline (7.9% [standard deviation {s.d.}, 0.66] and 7.9% [0.70], respectively) to week 24 in HbA1c (least squares mean [standard error {s.e.}] change −0.62% [0.09] vs −0.11% [0.09]; P < .0001, respectively) and higher proportions of patients achieved HbA1c targets. Two‐hour PPG, daily mean SMPG and mean BW were reduced further and daily BI dose was lower with lixisenatide than placebo (−1.12 kg vs 0.04 kg [ P < .0001]; −3.0 U vs −1.9 U [ P = .0033], respectively). Treatment‐emergent adverse events were greater with lixisenatide than placebo (63.8% vs 40.8%, respectively). The incidence of symptomatic hypoglycaemia was similar (lixisenatide 15.6% vs placebo 13.5%). Conclusions In Asian patients insufficiently controlled on BI ± metformin, lixisenatide was superior to placebo in glycaemic control, with a tolerability profile in line with other glucagon‐like peptide‐1 receptor agonists. Clinical trial number NCT01632163 ( clinicaltrials.gov ).