학술논문

Real-world effectiveness of IDegLira compared with intensified conventional insulin therapy in adults with type 2 diabetes: a retrospective cohort study.
Document Type
Article
Source
BMC Endocrine Disorders. 9/14/2022, Vol. 22 Issue 1, p1-11. 11p.
Subject
*INSULIN therapy
*DRUG efficacy
*GLYCOSYLATED hemoglobin
*COMBINATION drug therapy
*BODY weight
*CONFIDENCE intervals
*INJECTIONS
*GLYCEMIC control
*RETROSPECTIVE studies
*CLINICS
*TYPE 2 diabetes
*COMPARATIVE studies
*WEIGHT gain
*INSULIN
*DESCRIPTIVE statistics
*HYPOGLYCEMIA
*WEIGHT loss
*GLUCAGON-like peptide-1 agonists
*ODDS ratio
*CONTROL groups
*LONGITUDINAL method
*DRUG administration
*DRUG dosage
*THERAPEUTICS
*EVALUATION
Language
ISSN
1472-6823
Abstract
Background: IDegLira is a fixed-ratio combination of insulin degludec and liraglutide with proven efficacy against simpler regimens and non-inferiority against basal-bolus insulin therapy. However, the evaluation of its real-world effectiveness is hindered by technical issues and requires further exploration. Thus we aimed to compare effectiveness of insulin degludec/liraglutide (IDegLira) versus intensified conventional insulin therapy (ICT) for type 2 diabetes in a real-world setting. Methods: This retrospective cohort study from an outpatient clinic in Hungary included people who initiated IDegLira due to inadequate glycaemic control (HbA1c > 7.0% [53.0 mmol/mol]) with oral and/or injectable antidiabetic drugs. Data were compared with a historical cohort who initiated ICT. Outcomes included HbA1c, body weight, and hypoglycaemia differences over 18 months of follow-up. Results: Data were included from 227 and 72 people who initiated IDegLira and ICT, respectively. Estimated mean difference (MD) in HbA1c at 18 months favoured IDegLira versus ICT (MD 0.60, 95% CI 0.88–0.32 [MD 6.6 mmol/mol, 95% CI 9.6–3.5]). More people reached target HbA1c ≤7.0% (53.0 mmol/mol) with IDegLira than ICT (odds ratio 3.36, 95% CI 1.52–7.42). IDegLira treatment was associated with weight loss compared with gain for ICT (MD 6.7 kg, 95% CI 5.0–8.5). The hazard ratio for hypoglycaemia comparing IDegLira with ICT was 0.18 (95% CI 0.08–0.49). Conclusions: Treatment with IDegLira over 18 months resulted in greater HbA1c reductions, weight loss versus gain, and a lower rate of hypoglycaemia versus ICT in people with type 2 diabetes. [ABSTRACT FROM AUTHOR]