Once-a-Week Insulin Matches Daily Insulin in Lowering HbA1c: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on topline results of the international QWINT-2 and QWINT-4 studies announced by Eli Lilly.

The studies

QWINT-2 and QWINT-4 were parallel-design, open-label, treat-to-target randomized controlled trials comparing the safety and efficacy of Lilly's once-weekly efsitora to daily basal insulin degludec for 52 weeks and to basal insulin glargine for 26 weeks, respectively.

In the QWINT-2 study, 928 insulin-naïve adults with type 2 diabetes (T2D) were randomly assigned to receive either efsitora once weekly or insulin degludec once daily; the study design also allowed investigators to assess the investigational agent’s efficacy and safety among study participants using and not using GLP-1 receptor agonists.

The 26-week phase 3 QWINT-4 trial enrolled 730 adults with T2D previously treated with basal insulin glargine and at least 2 daily injections of mealtime insulin. Participants were randomly assigned to receive efsitora once weekly or insulin glargine once daily, both of which were administered with insulin lispro.

The findings

• QWINT-2: At week 52, HbA1c reduction was 1.34% with efsitora compared to 1.26% for insulin degludec; final HbA1c levels were 6.87% and 6.95%, for the efficacy estimand, satisfying the study's primary endpoint.

• QWINT-4: Efsitora was noninferior to traditional daily insulin glargine at week 26 for the primary endpoint of reduced HbA1c.

• The safety and tolerability profile for efsitora in both trials was favorable.

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