Table 2.
Key efficacy results for clinical practice studies and observational studies examining combination therapy of GLP-1 receptor agonists and basal insulin in type 2 diabetes
| HbA1c (%) | Body Wt (kg)‖ | Δ Insulin dose (total daily) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| References | Study type | Treatment duration | Treatment regimen | BL | Δ | BL | Δ | BL | Δ |
| Thong et al. 43 | P Obs | Median 26 weeks | EXEN → Ins ± MET ± SU ± TZD§ (N = 1257) | 9.55 | ↓0.51 | 112.7 | ↓5.8 | 120 U | ↓42 U |
| Median 27 weeks | <Control > EXEN without Ins ± MET ± SU ± TZD§ (N = 2936) | 9.42 | ↓0.94 | 114.1 | ↓5.5 | NA | |||
| Pawaskar et al. 44 | R Obs | Mean 12 months | EXEN → BasalIns (N = 1320)BasalIns → EXEN (N = 432) | 8.5 | ↓0.5 | 111.4 | ↓4.0 | NR | |
| Levin et al. 46 | R Obs | 24 months | InsGlar → EXEN ± MET ± SU ± TZD (N = 44) | 8.9 | ↓1.0 | 112.2 | ↑0.7 | NA | |
| EXEN → InsGlar ± MET ± SU ± TZD (N = 121) | 8.7 | ↓0.7 | 108.4 | ↓2.5 | 0.37 U/kg | ↑0.10 U/kg | |||
| Sheffield et al. 16 | R Obs | mean 14.6 months | EXEN → Ins (N = 134) | 8.39 | ↓0.87 | 111.1 | ↓5.2 | 63 U (all) 48 U (basal)26 U (bolus) | ↓5 U (all) ↑1 U (basal)↓9 U (bolus) |
| Levin et al. 45 | R Obs | 12 months | InsGlar → EXEN (N = 141) | 8.9 | ↓0.9 | NR | NA | ||
| EXEN → InsGlar (N = 281) | 8.4 | ↓0.4 | NR | NR | |||||
| Yoon et al. 41* | R Obs | mean 50 weeks | EXEN → Ins ± MET ± TZD ± SU ± α-glucosidase inhibitor ± meglitinide (N = 188) | 8.05 | ↓0.54 | 117.8 | ↓5.5 | 99.9 U (all) 62.9 U (basal)29.4 U (prandial) | ↓5.4 U (all) ↑ ∼ 4.5 U (basal)↓ ∼ 16.5 U (prandial) |
| Nayak et al. 47 | P Obs | ∼6 months | EXEN → Ins + MET (N = 160) | 8.8 | ↓0.2 | 121.8 | ↓10.7 | 144 U | ↓93 U |
| Viswanathan et al. 42 | R Obs | mean 26 weeks | EXEN → Ins ± OAM(s) (N = 38) | 7.7 | ↓0.6 | 116.4 | ↓6.4 | 58.4 U (basal) 50.4 U (rapid)72.9 U (mix) | ↓5.3 U (basal) ↓13.8 U (rapid)↓44.6 U (mix) |
| Phillips et al. 48 | CP | 6 months | EXEN → MET + SU + InsGlar (N = 50) | 8.2 | ↓1.4 | 133.6 | ↑4.1 | 105 U | ↓8 U |
| Anholm et al. 39 | CP | Mean 6.4 months | LIRA → Ins† ± MET ± SU (N = 115) | 8.6 | ↓0.8 | 107.7 | ↓5.1 | 69 U | ↓28 U |
| Mean 7 months | LIRA → MET ± SU ± DPP-4 (N = 152) | 8.7 | ↓1.4 | 106.4 | ↓3.5 | NA | |||
| Christofides et al. 64¶ | CP | ≤21 months | EXEN → Ins ± MET ± PIO (N = 109) | 8.1 | ↓0.78 | NR | ↓4.3 | NR | |
| EXEN → MET ± PIO (N = 132) | 7.1 | ↓0.79 | NR | ↓1.7 | NA | ||||
| Houser et al. 79¶ | CP | 48 months | EXEN → Ins ± MET ± PIO (N = 47) | 8.1 | ↓1.16 | NR | ↓7.3 | NR | |
| EXEN → MET ± PIO (N = 50) | 7.1 | ↓1.06 | NR | ↓6.8 | NA | ||||
| Vithian et al. 49 | CP | Mean 19 weeks | EXEN → Ins ± OAM (unspecified) (N = 42) | 8.9 | ↓0.75 | NR | ↓5.41% | NR | |
| Rachabattula et al. 61 | R Obs | 12 months | EXEN → Ins ± MET (N = 101) | 9.4 | ↓1.3 | 120.5 | ↓4.5 | 135 U | ↓21 U |
| Lind et al. 40 | R obs | Mean 7 months | LIRA (N = 40) or EXEN (N = 21) → Ins‡ ± MET ± SU | 8.9 | ↓1.0 | 111.1 | ↓7.1 | 91.1 U | ↓38.6 U |
BasalIns, basal insulin; BL, baseline; CP, clinical practice; DPP-4, dipeptidyl peptidase 4 inhibitor; EXEN, exenatide twice daily formulation; Ins, insulin; InsGlar, insulin glargine; LIRA, liraglutide; MET, metformin; NA, not applicable; NR, not reported; PIO, pioglitazone; P Obs, prospective observational; R Obs, retrospective observational; SU, sulphonylurea; TZD, thiazolidinedione.
Efficacy results represent 18 to 27 months.
27% of patients were using InsGlar, and 35% were using premix insulin.
52.5% of patients received multiple daily injections, with 34% receiving basal and 11.5% receiving premix insulin.
Other OAMs were used, but frequency was low.
These studies present data for the same patient population followed for different lengths of time.
Body weight changes are reported in kg unless otherwise specified. Insulin doses reflect total daily doses unless otherwise specified.