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Efficacy and safety of iGlarLixi versus IDegLira in adults with type 2 diabetes inadequately controlled by glucagon‐like peptide‐1 receptor agonists: a systematic literature review and indirect treatment comparison
Author(s) -
Home Philip D.,
Aroda Vanita R.,
Blonde Lawrence,
Guyot Patricia,
Shaunik Alka,
Fazeli Mir Sohail,
Goswami Hardik,
Kalra Sanjay,
Pourrahmat MirMasoud
Publication year - 2020
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.14136
Subject(s) - postprandial , type 2 diabetes , medicine , glucagon like peptide 1 receptor , agonist , hypoglycemia , glucagon like peptide 1 , liraglutide , diabetes mellitus , endocrinology , receptor
Abstract Aims To estimate the relative treatment effect between the fixed‐ratio combinations iGlarLixi and IDegLira (glucagon‐like peptide 1 receptor agonist with basal insulin) in people with type 2 diabetes inadequately controlled on a glucagon‐like peptide 1 receptor agonist. Materials and Methods A systematic literature review of randomized controlled trials followed by an indirect treatment comparison was performed to compare the efficacy and safety of the available fixed‐ratio combinations. Main outcomes were glycated haemoglobin (HbA1c) change and target achievement [<6.5% and <7.0% (<48 and <53 mmol/mol)], fasting plasma glucose, self‐monitored plasma glucose, body weight, and incidence and rate of hypoglycaemia. Results From 4850 abstracts screened, 78 qualified for full‐text article review and two randomized controlled trials were included. Baseline characteristics were similar in the two studies. The mean difference at 26 weeks between IDegLira and iGlarLixi was −0.36 (95% credible intervals −0.58, −0.14) % [−3.9 (−6.3, −1.5) mmol/mol] for HbA1c and −1.0 (−1.6, −0.4) mmol/L for fasting plasma glucose. No significant differences were found in HbA1c target attainment, preprandial or postprandial self‐monitored plasma glucose, or body weight change. Formal comparisons of hypoglycaemia were limited by differences in definitions between the studies: in non‐sulphonylurea users, incidence was 28% for IDegLira (‘confirmed’ at ≤3.1 mmol/L); for iGlarLixi, incidence was 9% (‘documented symptomatic’ at <3.0 mmol/L). Conclusions Results of this indirect treatment comparison using two studies suggest iGlarLixi and IDegLira appear to offer similar benefits for HbA1c target achievement. However, the findings suggest differences in other glycaemia results and hypoglycaemia, which may reflect differences in study design and titration approaches.