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Published in: Drugs 12/2017

01-08-2017 | Adis Drug Evaluation

Insulin Glargine/Lixisenatide: A Review in Type 2 Diabetes

Author: Lesley J. Scott

Published in: Drugs | Issue 12/2017

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Abstract

Subcutaneous insulin glargine/lixisenatide (Suliqua™) is a titratable, fixed-ratio combination of a long-acting basal insulin analogue and a glucagon-like peptide-1 (GLP-1) receptor agonist for the treatment of adult patients with inadequately controlled type 2 diabetes. Once-daily insulin glargine/lixisenatide, in combination with metformin, provided effective glycaemic control and was generally well tolerated in the 30-week, multinational, phase 3 LixiLan-O and LixiLan-L trials in insulin-naive and -experienced adult patients with inadequately controlled type 2 diabetes. Although long-term clinical experience with this fixed-ratio combination is currently lacking, given its convenient once-daily regimen and beneficial effects on glycaemic control and bodyweight loss in the absence of an increase in the incidence of hypoglycaemia, insulin glargine/lixisenatide is an emerging option for the treatment of adult patients with type 2 diabetes to improve glycaemic control when this has not been provided by metformin alone or metformin combined with another OAD or basal insulin.
Appendix
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Literature
1.
2.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2012;35(Suppl 1):S64–71.CrossRef
3.
Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centered approach. Update to position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38:140–9.CrossRefPubMed
4.
5.
Milligan S. Combination therapy for improvement of long-term macrovascular and microvascular outcomes in type 2 diabetes: rationale and evidence for early initiation. J Diabetes Complicat. 2016;30:1177–85.CrossRefPubMed
6.
Wilding JPH, Bain SC. Role of incretin-based therapies and sodium-glucose co-transporter-2 inhibitors as adjuncts to insulin therapy in type 2 diabetes, with special reference to IDegLira. Diabet Med. 2016;33(7):864–76.CrossRefPubMed
7.
Nauck M. Incretin therapies: highlighting common features and differences in the modes of action of glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors. Diabet Obes Metabol. 2016;18(3):203–16.CrossRef
8.
9.
Eng C, Kramer CK, Zinman B, et al. Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis. Lancet. 2014;384:2228–34.CrossRef
10.
European Medicines Agency. Suliqua 100 units/mL + 50 micrograms/mL solution in a prefilled pen, Suliqua 100 units/mL + 33 micrograms/mL solution in a prefilled pen: summary of product characteristics. 2017. http://​www.​ema.​europa.​eu. Accessed 8 Mar 2017.
11.
Sanofi-aventis US LLC. Soliqua™ 100/33 (insulin glargine and lixisenatide injection), for subcutaneous use: US prescribing information. 2016. http://​www.​fda.​gov/​. Accessed 14 Mar 2017.
12.
Blair H, Keating GM. Insulin glargine 300 U/mL: a review in diabetes mellitus. Drugs. 2016;76:363–74.CrossRefPubMed
13.
Dunn CJ, Plosker GL, Keating GM, et al. Insulin glargine: an updated review of its use in the management of diabetes mellitus. Drugs. 2003;63(16):1743–78.CrossRefPubMed
14.
Scott LJ. Lixisenatide: a review of its use in patients with type 2 diabetes mellitus. BioDrugs. 2013;27(5):509–23.CrossRefPubMed
15.
Lorenz M, Pfeffer C, Steinsträßer A, et al. Effects of lixisenatide once daily on gastric emptying in type 2 diabetes: relationship to postprandial glycemia. Regul Pept. 2013;185:1–8.CrossRefPubMed
16.
Meier JJ, Menge B, Schenker N, et al. Mechanisms of action of the glucose-lowering effect of lixisenatide in combination with insulin glargine [abstract no. 281-OR]. Diabetes. 2015;64(Suppl 1):A74.
17.
Kovatchev B, Umpierrez G, Renard E. The differential and combined action of insulin glargine and lixisenatide on the fasting and post-prandial components of glucose control [abstract no. 3]. Diabetologia. 2016;59(Suppl 1):S2.
18.
Rosenstock J, Aronson R, Grunberger G, et al. Benefits of LixiLan, a titratable fixed-ratio combination of insulin glargine plus lixisenatide, versus insulin glargine and lixisenatide monocomponents in type 2 diabetes inadequately controlled on oral agents: the LixiLan-O randomized trial. Diabetes Care. 2016;39(11):2026–35.CrossRefPubMed
19.
Rosenstock J, Diamant M, Aroda VR, et al. Efficacy and safety of LixiLan, a titratable fixed-ratio combination of lixisenatide and insulin glargine, versus insulin glargine in type 2 diabetes inadequately controlled on metformin monotherapy: the LixiLan proof-of-concept randomized trial. Diabetes Care. 2016;39(9):1579–86.CrossRefPubMed
20.
Davies M, Russell-Jones D, Barber TM, et al. iGlarLixi fixed-ratio combination in patients with HbA1c ≥9%: LixiLan-O subgroup analysis [abstract]. 2017. In: 77th ADA Meeting; 2017.
21.
Handelsman Y, Chovanes C, Dex T, et al. Efficacy and safety of insulin glargine/lixisenatide fixed-ratio combination in elderly patients with T2D [abstract no. 954-P]. Diabetes. 2016;65(Suppl 1):A246.
22.
Davis M, Leiter LA, Grunberger G, et al. Impact of baseline HbA1c, BMI, and diabetes duration on the efficacy and safety of LixiLan (insulin glargine/lixisenatide titratable fixed-ratio combination) vs. insulin glargine and lixisenatide in the LixiLan-O trial [abstract no. 1028-P]. Diabetes. 2016;65(Suppl 1):A268.
23.
Aroda VR, Rosenstock J, Wysham C, et al. Efficacy and safety of LixiLan, a titratable fixed-ratio combination of insulin glargine plus lixisenatide in type 2 diabetes inadequately controlled on basal insulin and metformin: the LixiLan-L randomized trial. Diabetes Care. 2016;39(11):1972–80.CrossRefPubMed
24.
Wysham C, Bonadonna RC, Aroda V, et al. Consistent findings in glycaemic control, body weight and hypoglycaemia with iGlarLixi (insulin glargine/lixisenatide titratable fixed-ratio combination) vs insulin glargine across baseline HbA1c, BMI and diabetes duration categories in the LixiLan-L trial. Diabetes Obes Metab. 2017. doi:10.​1111/​dom.​12961.
25.
Ritzel R, Vidal J, Aroda VR, et al. Efficacy and safety across the final dose ranges in patients with T2DM receiving insulin glargine/lixisenatide fixed-ratio combination in the LixiLan-L trial [abstract no. 1024-P]. Diabetes. 2016;65(Suppl 1):A266–7.
26.
ORIGIN Trial Investigators. Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med. 2012;367(4):319–28.CrossRef
27.
Pfeffer MA, Claggett B, Diaz R, et al. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N Engl J Med. 2015;373(23):2247–57.CrossRefPubMed
28.
29.
Levin PA. Practical combination therapy based on pathophysiology of type 2 diabetes. Diabetes Metabol Syndr Obesity Targets Ther. 2016;9:355–69.CrossRef
30.
Greig SL, Scott LJ. Insulin degludec/liraglutide: a review in type 2 diabetes. Drugs. 2015;75(13):1523–34.CrossRefPubMed
31.
European Medicines Agency. Xultophy 100 units/mL + 3.6 mg/mL liraglutide solution for injection: summary of product characteristics. 2014. http://​www.​ema.​europa.​eu. Accessed 21 March 2017.
32.
Van Gaal L, Scheen A. Weight management in type 2 diabetes: current and emerging approaches to treatment. Diabetes Care. 2015;38:1161–72.CrossRefPubMed
33.
Riddle MC, Forst T, Aronson R, et al. Adding once-daily lixisenatide for type 2 diabetes inadequately controlled with newly initiated and continuously titrated basal insulin glargine. Diabetes Care. 2013;36(9):2497–503.CrossRefPubMedPubMedCentral
34.
Riddle MC, Aronson R, Home P, et al. Adding once-daily lixisenatide for type 2 diabetes inadequately controlled by established basal insulin. Diabetes Care. 2013;36(9):2489–96.CrossRefPubMedPubMedCentral
35.
Seino Y, Min KW, Niemoeller E, et al. Randomized, double-blind, placebo-controlled trial of the once-daily GLP-1 receptor agonist lixisenatide in Asian patients with type 2 diabetes insufficiently controlled on basal insulin with or without a sulfonylurea (GetGoal-L-Asia). Diabetes Obes Metab. 2012;14(10):910–7.CrossRefPubMedPubMedCentral
36.
Rosenstock J, Guerci B, Hanefeld M, et al. Prandial options to advance basal insulin glargine therapy: testing lixisenatide plus basal insulin versus insulin glulisine either as basal-plus or basal-bolus in type 2 diabetes: the GetGoal Duo-2 trial. Diabetes Care. 2016;39(8):1318–28.CrossRefPubMed
37.
Eto K, Naito Y, Seino Y. Evaluation of efficacy and safety of lixisentide add-on treatment to basal insulin therapy among T2DM patients with different body mass indices from GetGoal trials. Diabetol Metab Syndr. 2015;7:106.CrossRefPubMedPubMedCentral
38.
Zannad F, Stough WG, Lipicky RJ, et al. Assessment of cardiovascular risk of new drugs for the treatment of diabetes mellitus: risk asessment vs. risk aversion. Eur Heart J. 2016;2:200–5.
39.
European Medicines Agency. Guidelines on clinical investiagtion of medicinal products in the treatment or prevention of diabetes mellitus. 2012. http://​www.​ema.​europa.​eu. Accessed 22 Mar 2017.
Metadata
Title
Insulin Glargine/Lixisenatide: A Review in Type 2 Diabetes
Author
Lesley J. Scott
Publication date
01-08-2017
Publisher
Springer International Publishing
Published in
Drugs / Issue 12/2017
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.1007/s40265-017-0783-4

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