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Insulin glargine/lixisenatide fixed‐ratio combination ( iGlarLixi ) compared with premix or addition of meal‐time insulin to basal insulin in people with type 2 diabetes: A systematic review and Bayesian network meta‐analysis
Author(s) -
Home Philip,
Blonde Lawrence,
Kalra Sanjay,
Ji Lig,
Guyot Patricia,
BrulleWohlhueter Claire,
Murray Erin,
Shah Roshan,
Sayre Toby,
Shaunik Alka
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.14148
Subject(s) - basal insulin , insulin glargine , lixisenatide , insulin , type 2 diabetes , medicine , endocrinology , diabetes mellitus
Aim To assess the efficacy and safety of iGlarLixi, a fixed‐ratio combination of insulin glargine 100 U/mL and lixisenatide, relative to premix insulin and other insulin options through network meta‐analysis. Methods A systematic literature search identified randomized controlled trials (RCTs) comparing iGlarLixi, premix insulin or basal insulin (BI) in combination with meal‐time insulin, in people inadequately controlled with BI. Eligible RCTs were compared using Bayesian network meta‐analysis. Results Eight RCTs, some open‐label, involving 3538 participants, with a study duration of 24‐30 weeks were included. The estimated difference in HbA1c reduction with iGlarLixi compared with premix insulin was −0.50%‐units (95% credible interval: −0.93 to −0.06) with 98% probability of iGlarLixi being superior to premix. Estimates for iGlarLixi versus meal‐time + BI (thrice‐daily meal‐time insulin + basal) and basal‐plus (once‐daily meal‐time insulin + BI) were −0.35 (−0.89 to +0.13)%‐units and −0.68 (−1.18 to −0.17)%‐units with probabilities of real difference of 94% and 99%, respectively. Safety outcome analysis suggested that iGlarLixi had lower rates of both confirmed and documented symptomatic hypoglycaemia compared with premix insulin (probabilities of 85% and 93%, respectively) and lower weight gain (probability 98%). Conclusions iGlarLixi showed similar or improved efficacy and safety versus other intensification choices from BI included in this study, providing a clinically relevant treatment option in people with type 2 diabetes not well controlled on BI.