Efficacy and safety of iGlarLixi versus IDegAsp in people with type 2 diabetes inadequately controlled with basal insulin: A systematic literature review and network meta-analysis of non-Asian studies

Abstract

Aims: To estimate the relative treatment effect of iGlarLixi (a fixed-ratio combination of insulin glargine 100 U/mL plus lixisenatide) versus premixed insulin IDegAsp (insulin degludec plus insulin aspart) in people with type 2 diabetes (T2D) who advanced from basal insulin to iGlarLixi or IDegAsp in non-Asian studies.

Materials and methods: Randomized controlled trials (RCTs) were identified in a systematic review by searching Embase (including congress abstracts from 2021 to 2023), MEDLINE® and CENTRAL on 10 October 2023. Treatment outcomes from non-Asian RCTs for people with T2D previously treated with basal insulin, who switched to iGlarLixi or IDegAsp, were compared using a network meta-analysis (NMA). Data analysis was performed using R, version 4.0.2.

Results: The NMA included four RCTs (N = 2535). The results of the NMA showed that iGlarLixi (n = 810) was associated with a significantly greater reduction in HbA1c versus IDegAsp (n = 454) (mean difference [MD]: -0.39 [95% credible interval, CrI: -0.58, -0.21] %-units). iGlarLixi was also associated with a significantly greater likelihood of achieving an HbA1c of <7.0% (risk ratio: 1.42, 95% CrI: 1.18, 1.71). A greater reduction in postprandial glucose was observed with iGlarLixi versus IDegAsp (MD: -1.38 [95% CrI: -2.15, -0.63] mmol/L). A body weight benefit that favoured iGlarLixi versus IDegAsp was documented (MD: -1.54 [95% CrI: -2.26, -0.84] kg). Hypoglycaemia evaluation was inconclusive due to definitional differences between trials.

Conclusions: Once-daily iGlarLixi was associated with superior blood glucose control and body weight benefit compared with IDegAsp in insulin-experienced populations with T2D in non-Asian RCTs.

Keywords: fixed‐ratio combination; iGlarLixi; insulin therapy; network meta‐analysis; type 2 diabetes.