A Systematic Literature Review and Network Meta-Analysis of Once-Weekly Icosema With Daily Fixed-Dose Combinations of Basal Insulin and GLP-1 RA in Patients With Type 2 Diabetes After 52 Weeks of Treatment
Author(s)
Aparajita Tyagi, MSc1, Corinne LeReun, MSc2, Lauren Rengger, MSc2, Martin Bøg, PhD1, Palvi Gupta, MPharm2, Sunita Nair, PhD2.
1Novo Nordisk A/S, Søborg, Denmark, 2Clarivate Analytics, London, United Kingdom.
1Novo Nordisk A/S, Søborg, Denmark, 2Clarivate Analytics, London, United Kingdom.
OBJECTIVES: A network meta-analysis (NMA) was conducted based on studies identified via systematic literature review (SLR), to compare the 52-week efficacy and safety of novel once-weekly IcoSema versus daily fixed-dose combinations of basal insulin and GLP-1 RA, for the management of type 2 diabetes (T2D).
METHODS: A SLR was conducted [Embase, Medline, Cochrane] in November 2023 to identify randomised controlled trials (RCTs) which examined treatments of interest (IcoSema, IDegLira [Xultophy®] and IGlarLixi [Soliqua®]) at 52 ± 4 weeks. The study included multinational RCTs and excluded trials conducted exclusively in a specific region or country. Data was extracted for outcomes: change from baseline (CFB) glycated haemoglobin (HbA1c), body weight, basal insulin dose, and rate ratio (RR) of level 2 and level 2 or 3 hypoglycaemia. Fixed and random effects Bayesian NMAs were fitted.
RESULTS: Treatment with IcoSema was associated with significantly greater HbA1c reduction compared with IDegLira; treatment difference of -0.4% (95%CrI: [-0.56, -0.24]). IcoSema demonstrated a significantly better treatment effect on the CFB body weight and basal insulin dose at week 52 compared with IDegLira; the estimated relative effects of IcoSema versus IDegLira were -3.2kg (95%CrI: [-3.91, -2.5]) and -9.28 U/day (95%CrI: [-13.17, -5.38]), respectively. Compared with IDegLira, IcoSema demonstrated significantly lower rates of level 2 and level 2 or 3 hypoglycemia (RR [95%CrI]= 0.35 [0.27, 0.44] and 0.35 [0.26, 0.46], respectively). Comparison between IcoSema and IGlarLixi was not feasible at this time point, since the SLR did not identify any IGlarLixi trials with a 52 ± 4 weeks treatment duration.
CONCLUSIONS: Once-weekly IcoSema was associated with a significantly greater change in HbA1c and body weight after 52 weeks of treatment compared with daily IDegLira, while also demonstrating significantly lower basal insulin dose and level 2 and level 2 or 3 hypoglycaemia rates, in patients with inadequately controlled T2D.
METHODS: A SLR was conducted [Embase, Medline, Cochrane] in November 2023 to identify randomised controlled trials (RCTs) which examined treatments of interest (IcoSema, IDegLira [Xultophy®] and IGlarLixi [Soliqua®]) at 52 ± 4 weeks. The study included multinational RCTs and excluded trials conducted exclusively in a specific region or country. Data was extracted for outcomes: change from baseline (CFB) glycated haemoglobin (HbA1c), body weight, basal insulin dose, and rate ratio (RR) of level 2 and level 2 or 3 hypoglycaemia. Fixed and random effects Bayesian NMAs were fitted.
RESULTS: Treatment with IcoSema was associated with significantly greater HbA1c reduction compared with IDegLira; treatment difference of -0.4% (95%CrI: [-0.56, -0.24]). IcoSema demonstrated a significantly better treatment effect on the CFB body weight and basal insulin dose at week 52 compared with IDegLira; the estimated relative effects of IcoSema versus IDegLira were -3.2kg (95%CrI: [-3.91, -2.5]) and -9.28 U/day (95%CrI: [-13.17, -5.38]), respectively. Compared with IDegLira, IcoSema demonstrated significantly lower rates of level 2 and level 2 or 3 hypoglycemia (RR [95%CrI]= 0.35 [0.27, 0.44] and 0.35 [0.26, 0.46], respectively). Comparison between IcoSema and IGlarLixi was not feasible at this time point, since the SLR did not identify any IGlarLixi trials with a 52 ± 4 weeks treatment duration.
CONCLUSIONS: Once-weekly IcoSema was associated with a significantly greater change in HbA1c and body weight after 52 weeks of treatment compared with daily IDegLira, while also demonstrating significantly lower basal insulin dose and level 2 and level 2 or 3 hypoglycaemia rates, in patients with inadequately controlled T2D.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO3
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)