Lixisenatide plus basal insulin in patients with type 2 diabetes mellitus: a meta-analysis

J Diabetes Complications. Nov-Dec 2014;28(6):880-6. doi: 10.1016/j.jdiacomp.2014.07.007. Epub 2014 Jul 18.

Abstract

Aims: The efficacy of the once-daily prandial GLP-1 receptor agonist lixisenatide plus basal insulin in T2DM was assessed by pooling results of phase III trials.

Methods: A meta-analysis was performed of results from three trials in the GetGoal clinical program concerning lixisenatide or placebo plus basal insulin with/without OADs. The primary endpoint was change in HbA1c from baseline to week 24. Secondary endpoints were change in PPG, FPG, insulin dose, and weight from baseline to week 24. Hypoglycemia rates and several composite endpoints were assessed.

Results: Lixisenatide plus basal insulin was significantly more effective than basal insulin alone at reducing HbA1c at 24 weeks. Composite and secondary endpoints were improved significantly with lixisenatide plus basal insulin, with the exception of FPG, which showed no significant difference between the groups. Lixisenatide plus basal insulin was associated with an increased incidence of hypoglycemia versus basal insulin alone.

Conclusions: Lixisenatide plus basal insulin resulted in significant improvement in glycemic control versus basal insulin alone, particularly in terms of controlling PPG. Prandial lixisenatide in combination with basal insulin is a suitable option for treatment intensification in patients with T2DM insufficiently controlled with basal insulin, as these agents have complementary effects on PPG and FPG, respectively.

Trial registration: ClinicalTrials.gov NCT00715624 NCT00899958 NCT00975286.

Keywords: Basal insulin; Combination; Lixisenatide; Meta-analysis; Prandial.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged
  • Clinical Trials, Phase III as Topic / statistics & numerical data
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Drug Therapy, Combination / adverse effects
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Insulin Detemir
  • Insulin, Long-Acting / administration & dosage*
  • Insulin, Long-Acting / adverse effects
  • Male
  • Middle Aged
  • Peptides / administration & dosage*
  • Peptides / adverse effects
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Treatment Outcome

Substances

  • Hypoglycemic Agents
  • Insulin, Long-Acting
  • Peptides
  • Insulin Detemir
  • lixisenatide

Associated data

  • ClinicalTrials.gov/NCT00715624
  • ClinicalTrials.gov/NCT00899958
  • ClinicalTrials.gov/NCT00975286