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Icodec with app superior to once-daily basal insulin analogues for change in glycated hemoglobin

For insulin-naive adults with type 2 diabetes, once-weekly insulin icodec (icodec) titrated with a dosing guide app (icodec with app) is superior for change in glycated hemoglobin A1c (HbA1c) level versus once-daily basal insulin analogues (OD analogues), according to a study published online Sept. 26 in the Annals of Internal Medicine.

Harpreet S. Bajaj, M.D., M.P.H., from LMC Diabetes and Endocrinology in Brampton, Ontario, Canada, and colleagues compared the effectiveness and safety of icodec with app versus OD analogues dosed per standard practice in a 52-week randomized, phase 3a trial with real-world elements. A total of 1,085 insulin-naive adults with type 2 diabetes from 176 sites in seven countries were included.

The researchers found that the estimated mean change in HbA1c level from baseline to week 52 was greater with icodec with app versus OD analogue; prespecified hierarchical testing confirmed noninferiority and superiority (estimated treatment difference [ETD], −0.38 percentage points). Patient-reported outcomes at 52 weeks were more favorable for icodec with app than OD analogues (ETD, 3.04 for the Treatment Related Impact Measure for Diabetes compliance domain score and 0.78 for change in the Diabetes Treatment Satisfaction Questionnaire total treatment satisfaction score). Both treatments had low and similar rates of clinically significant or severe hypoglycemia.

“Once-weekly icodec with a dosing guide app could conceivably address several challenges seen in everyday practice, including inadequate dose titration and nonadherence to prescribed treatment regimens,” the authors write.

The study was funded by Novo Nordisk.

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