A new one weekly insulin achieved the same efficacy as daily injections in patients with type 2 diabetes. In clinical trials, insulin effector alfa (efsitor ) used once a week led to a reduction in glycated hemoglobin (HbA1C) that was non-inferior to the daily injection, which is widely used worldwide.
The results of the studies, released last week by Eli Lilly and Company, were considered promising, mainly due to the potential of weekly insulin to promote quality of life for patients with diabetes. With efficacy very close to that of daily basal insulin, the weekly injection managed to control the disease with a smaller number of injections – in one year, there will be only 52, instead of 365 .
The analyses were divided into two phase 3 clinical studies: QWINT-1, which evaluated the use of weekly insulin in patients with type 2 diabetes who had never used any type of insulin injection; and QWINT-3, carried out in patients with the disorder, but who were already undergoing treatment with daily basal insulin injections.
According to the study, among those who had never used insulin to treat diabetes, weekly application reduced glycated hemoglobin by 1.31%, compared to 1.27% for daily insulin glargine. This resulted in glycated hemoglobin of 6.92% and 6.96%, respectively.
Among those who switched from daily to weekly treatment, reductions in glycated hemoglobin were also observed. Weekly insulin reduced HbA1C by 0.86% compared with the 0.75% decrease caused by daily insulin degludec. This resulted in glycated hemoglobin of 6.93% and 7.03%, respectively.
“Weekly insulins like efsitora have the potential to transform diabetes care as we know it,” said Jeff Emmick, senior vice president of product development at Lilly, in a press release. “Many patients are reluctant to start insulin therapy because of the burden they feel.”
“We are talking about replacing 365 daily injections of basal insulin with just 52 injections and still maintaining the same efficacy and safety profile that doctors are already accustomed to prescribing to their patients. This simplification also helps with treatment adherence and the quality of life of patients,” highlights Luiz Magno, senior director of the medical area at Lilly Brazil.
How were the studies done?
Both the QWINT-1 and QWINT-3 studies evaluated the efficacy and safety of weekly insulin versus daily insulin. However, the first study lasted 52 weeks and involved 796 people with diabetes who were not previously using insulin, from the United States, Argentina, Mexico, and Puerto Rico.
They were randomized (i.e., randomly assigned) to receive either once-weekly efsitora or once-daily insulin glargine administered subcutaneously. All efsitora-treated participants received a starting dose of 100 units, followed by a fixed-dose escalation to achieve a fasting glucose target of 80–130 mg/dL.
Fasting blood glucose was measured every 4 weeks, and participants were escalated to fixed doses of 150 units, 250 units, and 400 units as appropriate. Participants with fasting blood glucose greater than 130 mg/dL at or after 16 weeks were transitioned to flexible dosing. The objective was to assess the effectiveness of daily insulin at week 52.
QWINT-3 included 986 participants from the United States, Argentina, Hungary, Japan, Korea, Poland, Puerto Rico, Slovakia, Spain, and Taiwan who were followed for 78 weeks, with safety follow-ups every 5 weeks. They were randomly assigned to receive either once-weekly efsitora or once-daily insulin degludec administered subcutaneously. The goal was to assess the efficacy of daily insulin at week 26.
What is insulin effector?
Insulin efsitora is a weekly basal insulin specifically designed for once-weekly subcutaneous administration. Weekly insulin has the potential to provide more stable glucose levels, i.e., lead to less variability in blood sugar levels, throughout the week. Efsitora is currently undergoing phase 3 studies for patients with type 1 and 2 diabetes.
On Tuesday (10), the results of other clinical studies carried out with weekly insulin were released at the 2024 Annual Meeting of the European Association for the Study of Diabetes.
In QWINT-2, published in The New England Journal of Medicinetreatment with was evaluated in patients with type 2 diabetes who had never used insulin, compared with the use of daily insulin degludec. Efsitora helped adults without previous insulin treatment, whether or not using GLP-1 receptor agonists (such as Ozempic), achieve a glycated hemoglobin of less than 7%, a consistent reduction.
Already in QWINT-5, published in The Lancetthe use of daily insulin was evaluated in patients with type 1 diabetes who required daily basal insulin injections and multiple mealtime insulin injections. In the study, efsitor reduced glycated hemoglobin by 0.53% compared with 0.59% for insulin degludec, resulting in an HbA1C of 7.37% and 7.32%, respectively.
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This content was originally published in Weekly insulin demonstrates similar efficacy to daily insulin in study on the CNN Brasil website.
Source: CNN Brasil
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