IDegLira improves patient reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal-bolus therapy.

AIMS: Basal-bolus therapy is associated with greater treatment burden and lower adherence compared with more simplified regimens. This post hoc analysis studied the difference between insulin degludec/liraglutide (IDegLira) and basal-bolus therapy on number of injections, dose adjustments and patient outcomes, in DUAL VII.

MATERIALS AND METHODS: DUAL VII was a 26-week, open-label trial, where patients with uncontrolled type 2 diabetes on metformin and insulin glargine 100 units/mL (20-50U) were randomised 1:1 to IDegLira (N=252) or basal-bolus (insulin glargine U100 + insulin aspart ≤4 times/day; N=254). This post hoc analysis reports the observed mean number of injections and cumulative dose adjustments during 26 weeks of treatment. Patient reported outcomes (Treatment-Related Impact Measure - Diabetes [TRIM-D] and Short Form-36 Health Survey version 2 [SF-36v2]) were collected at scheduled visits and change from baseline scores calculated.

RESULTS: The clinical benefits (non-inferior HbA1c reductions, weight benefit, less hypoglycaemia) of IDegLira versus basal-bolus therapy were achieved with fewer cumulative dose adjustments (16.6 vs. 217.2, respectively) and fewer injections (1 vs. ≥3 per day, respectively). Patients treated with IDegLira experienced significant improvements across all TRIM-D domains compared with basal-bolus therapy. The SF-36v2 showed improvements in both treatment arms with no significant difference between the arms in the physical component summary, but there was a significant improvement for patients treated with IDegLira in the mental component summary (P = 0.0228).

CONCLUSIONS: These findings combined with the DUAL VII results, suggest that IDegLira, through a more simplified regimen versus basal-bolus therapy, may help improve patient adherence and improve patient outcomes related to diabetes management, treatment burden, and mental health, which in turn may assist in the timely achievement of glycaemic control in clinical practice.

CLINICAL TRIAL REGISTRATION: NCT02420262 This article is protected by copyright. All rights reserved.