TY - JOUR
T1 - Efficacy and safety of ideglira in older patients with type 2 diabetes
AU - Lingvay, Ildiko
AU - Handelsman, Yehuda
AU - Linjawi, Sultan
AU - Vilsbøll, Tina
AU - Halladin, Natalie
AU - Ranc, Kristina
AU - Liebl, Andreas
PY - 2019/2/1
Y1 - 2019/2/1
N2 - OBJECTIVE: The efficacy and safety of insulin degludec/liraglutide (IDegLira) in older patients has not yet been reported. This analysis aimed to evaluate the efficacy and safety of IDegLira in patients aged ≥65 years.METHODS: A post hoc analysis compared results of patients aged ≥65 versus <65 years from DUAL II, III, and V. These were 26-week, phase 3, randomized, twoarm parallel, treat-to-target trials in patients already taking injectable glucose-lowering agents. We evaluated 311 patients aged <65 and 87 patients aged ≥65 years from DUAL II, 326 patients <65 years and 112 patients ≥65 years from DUAL III, and 412 patients <65 years and 145 patients ≥65 years from DUAL V. Patients were randomized to IDegLira or insulin degludec (DUAL II), IDegLira or unchanged glucagon-like peptide 1-receptor agonist (GLP-1RA) (DUAL III), or IDegLira or IGlar U100 (DUAL V).RESULTS: In patients ≥65 years, hemoglobin A1C decreased to a greater extent with IDegLira than with comparators (estimated treatment differences, -1.0% [-1.5; -0.6]
95% confidence interval [CI], -0.8% [-1.0; -0.5]
95% CI, and -0.9% [-1.3; -0.6]95%CI) for DUAL II, V, and III, respectively; all P<.001). These mirrored results of patients <65 years of age. Hypoglycemia rates were lower with IDegLira versus basal insulin and higher versus unchanged GLP-1RA (estimated rate ratios, 0.5 [0.2; 1.6]
95% CI [ P = .242]; 0.3 [0.1; 0.5]
95% CI [ P<.001], and 11.8 [3.3; 42.8]
95% CI [ P<.001] for DUAL II, V, and III, respectively).
CONCLUSION: Patients aged ≥65 years on basal insulin or GLP-1RA can improve glycemic control with IDegLira, and it is well tolerated overall.ABBREVIATIONS: A1C = hemoglobin A1C; AE = adverse event; CI = confidence interval; Degludec = insulin degludec; EOT = end of trial; ETD = estimated treatment difference; FPG = fasting plasma glucose; GLP-1RA = glucagon-like peptide 1 receptor agonist; IDegLira = insulin degludec/liraglutide; IGlar U100 = insulin glargine 100 U/mL; SU = sulfonylurea; T2D = type 2 diabetes.
AB - OBJECTIVE: The efficacy and safety of insulin degludec/liraglutide (IDegLira) in older patients has not yet been reported. This analysis aimed to evaluate the efficacy and safety of IDegLira in patients aged ≥65 years.METHODS: A post hoc analysis compared results of patients aged ≥65 versus <65 years from DUAL II, III, and V. These were 26-week, phase 3, randomized, twoarm parallel, treat-to-target trials in patients already taking injectable glucose-lowering agents. We evaluated 311 patients aged <65 and 87 patients aged ≥65 years from DUAL II, 326 patients <65 years and 112 patients ≥65 years from DUAL III, and 412 patients <65 years and 145 patients ≥65 years from DUAL V. Patients were randomized to IDegLira or insulin degludec (DUAL II), IDegLira or unchanged glucagon-like peptide 1-receptor agonist (GLP-1RA) (DUAL III), or IDegLira or IGlar U100 (DUAL V).RESULTS: In patients ≥65 years, hemoglobin A1C decreased to a greater extent with IDegLira than with comparators (estimated treatment differences, -1.0% [-1.5; -0.6]
95% confidence interval [CI], -0.8% [-1.0; -0.5]
95% CI, and -0.9% [-1.3; -0.6]95%CI) for DUAL II, V, and III, respectively; all P<.001). These mirrored results of patients <65 years of age. Hypoglycemia rates were lower with IDegLira versus basal insulin and higher versus unchanged GLP-1RA (estimated rate ratios, 0.5 [0.2; 1.6]
95% CI [ P = .242]; 0.3 [0.1; 0.5]
95% CI [ P<.001], and 11.8 [3.3; 42.8]
95% CI [ P<.001] for DUAL II, V, and III, respectively).
CONCLUSION: Patients aged ≥65 years on basal insulin or GLP-1RA can improve glycemic control with IDegLira, and it is well tolerated overall.ABBREVIATIONS: A1C = hemoglobin A1C; AE = adverse event; CI = confidence interval; Degludec = insulin degludec; EOT = end of trial; ETD = estimated treatment difference; FPG = fasting plasma glucose; GLP-1RA = glucagon-like peptide 1 receptor agonist; IDegLira = insulin degludec/liraglutide; IGlar U100 = insulin glargine 100 U/mL; SU = sulfonylurea; T2D = type 2 diabetes.
KW - Aged
KW - Blood Glucose
KW - Diabetes Mellitus, Type 2/drug therapy
KW - Drug Combinations
KW - Glycated Hemoglobin A
KW - Humans
KW - Hypoglycemic Agents
KW - Insulin Glargine
KW - Insulin, Long-Acting/therapeutic use
KW - Liraglutide/therapeutic use
UR - http://www.scopus.com/inward/record.url?scp=85062431060&partnerID=8YFLogxK
U2 - 10.4158/EP-2018-0284
DO - 10.4158/EP-2018-0284
M3 - Journal article
C2 - 30383495
AN - SCOPUS:85062431060
SN - 1530-891X
VL - 25
SP - 144
EP - 155
JO - Endocrine Practice
JF - Endocrine Practice
IS - 2
ER -