ADA: Glycemic control up with weekly icodec versus daily insulin glargine

For adults with type 2 diabetes, glycemic control is significantly better with once-weekly icodec than once-daily insulin glargine U100, according to a study published online June 24 in the New England Journal of Medicine to coincide with the annual meeting of the American Diabetes Association, held from June 23 to 26 in San Diego.

Julio Rosenstock, M.D., from Velocity Clinical Research at Medical City in Dallas, and colleagues conducted a 78-week phase 3a trial involving adults with type 2 diabetes who had not previously received insulin. Participants were randomly assigned to receive once-weekly insulin icodec or once-daily insulin glargine U100 (492 in each group).

The researchers found that at 52 weeks, the mean reduction in glycated hemoglobin level was greater with icodec than with glargine U100 (from 8.50 to 6.93 percent and from 8.44 to 7.12 percent, respectively); the estimated between-group difference of −0.19 percentage points (95 percent confidence interval, −0.36 to −0.03) confirmed the noninferiority and superiority of icodec. Compared with glargine U100, the percentage of time spent in the glycemic range of 70 to 180 mg/dL was significantly higher with icodec (71.9 versus 66.9 percent), which confirmed superiority. The rates of combined clinically significant or severe hypoglycemia were 0.30 and 0.16 events per person-year of exposure with icodec and glargine U100, respectively, at week 52, and 0.30 and 0.16 per person-year of exposure, respectively, at week 83 (estimated rate ratios, 1.64 [95 percent confidence interval 0.98 to 2.75] and 1.63 [95 percent confidence interval, 1.02 to 2.61], respectively).

"The findings of the current trial highlight the totality of evidence for glycemic control with icodec," the authors write.

Several authors disclosed ties to pharmaceutical companies, including Novo Nordisk, which manufactures once-weekly insulin icodec and funded the study.

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