Abstract
Insulin degludec/liraglutide (Xultophy®), a fixed-ratio combination of an ultra-long-acting insulin analogue and a glucagon-like protein-1 (GLP-1) receptor agonist, is available in the EU for the management of inadequately controlled type 2 diabetes. Once-daily subcutaneous insulin degludec/liraglutide as add-on therapy to oral antidiabetics was effective and generally well tolerated in adults with inadequately controlled type 2 diabetes in several well designed 26-week phase III trials. In insulin-naive patients, add-on insulin degludec/liraglutide provided significantly greater improvements in glycated haemoglobin (HbA1c) levels than add-on insulin degludec, liraglutide or placebo, or unchanged GLP-1 receptor agonists (i.e. liraglutide or exenatide). In the extension of one of these trials, the efficacy of add-on insulin degludec/liraglutide was maintained for a total of 52 weeks. In insulin-experienced patients, add-on insulin degludec/liraglutide was significantly more effective with regard to improvements in HbA1c levels than add-on insulin degludec (at equivalent doses) or ongoing insulin glargine therapy. Add-on insulin degludec/liraglutide was associated with a lower incidence of confirmed hypoglycaemia than add-on insulin degludec in insulin-naive patients or ongoing insulin glargine in insulin-experienced patients, and a lower initial rate of nausea than add-on liraglutide. Thus, once-daily subcutaneous insulin degludec/liraglutide is a useful add-on therapy option for adult patients with inadequately controlled type 2 diabetes.
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The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the authors on the basis of scientific and editorial merit. Sarah Greig and Lesley Scott are salaried employees of Adis/Springer.
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The manuscript was reviewed by: S. Linjawi, Coffs Endocrine and Diabetes Services, Coffs Harbour, NSW, Australia; J. E. Thurman, SSM Medical Group—Endocrinology, St. Louis, MO, USA; V. C. Woo, Section of Endocrinology and Metabolism, University of Manitoba, Winnipeg, Manitoba, Canada.
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Greig, S.L., Scott, L.J. Insulin Degludec/Liraglutide: A Review in Type 2 Diabetes. Drugs 75, 1523–1534 (2015). https://doi.org/10.1007/s40265-015-0448-0
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DOI: https://doi.org/10.1007/s40265-015-0448-0