Once Weekly Insulin Icodec Article Review
Austin Rich, PharmD, Sullivan University College of Pharmacy & Health Sciences
In an article by Julio Rosenstock, et al, published in the New England Journal of Medicine on September 22, 2020, results of a phase 2 clinical trial comparing weekly insulin icodec to daily insulin glargine were reported. The goal of this study was to investigate the efficacy and safety of insulin icodec weekly injections compared to insulin glargine daily injections for initial insulin therapy in patients with type two diabetes mellitus (T2DM). There was a total of 247 participants included in the trial. Key inclusion criteria include hemoglobin A1c between 7.0 and 9.5%, stable doses of metformin > 1500 mg/day with or without a DPP4 inhibitor at half of maximum dose, and being insulin naive.
The primary outcome of investigation was the mean change in A1c from baseline to week 26 of therapy. The mean A1c in the icodec group decreased from 8.09% to an estimated mean of 6.69% (-1.33%) and decreased from 7.96% to 6.87% (-1.15%) in the glargine group. The estimated mean difference of -0.18% was not statistically significant (95% CI 0.38 to 0.02; p=0.08). Data from this study suggest that insulin icodec may have an equal efficacy and safety profile to insulin glargine for initial insulin therapy in patients with T2DM not achieving glycemic control with an additional benefit of reducing the number of injections.
Please refer to the corresponding file for a more comprehensive overview of the article.
Rosenstock J, Bajaj HS, Janez A, et al. Once-weekly insulin for type 2 diabetes without previous insulin treatment. N Engl J Med. 2020;383:2107-16.