Initiation of iGlarLixi Versus Basal-Bolus Insulin in Adults With Type 2 Diabetes Advancing From Basal Insulin Therapy: The SoliComplex Real-World Study

Background When type 2 diabetes is suboptimally controlled with basal insulin, prandial insulin injections are commonly added (i.e., a basal-bolus insulin regimen), which can increase treatment burden and hypoglycemia risk. The once-daily injectable iGlarLixi is an alternative treatment. Methods Thi...

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Veröffentlicht in:Diabetes spectrum 2023-01, Vol.36 (3), p.253-263
Hauptverfasser: Pantalone, Kevin M., Heller, Caroline, Lajara, Rosemarie, Lew, Elisheva, Li, Xuan, Dex, Terry, Kilpatrick, C. Rachel
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container_end_page 263
container_issue 3
container_start_page 253
container_title Diabetes spectrum
container_volume 36
creator Pantalone, Kevin M.
Heller, Caroline
Lajara, Rosemarie
Lew, Elisheva
Li, Xuan
Dex, Terry
Kilpatrick, C. Rachel
description Background When type 2 diabetes is suboptimally controlled with basal insulin, prandial insulin injections are commonly added (i.e., a basal-bolus insulin regimen), which can increase treatment burden and hypoglycemia risk. The once-daily injectable iGlarLixi is an alternative treatment. Methods This retrospective analysis of the U.S. Optum Clinformatics database compared outcomes in adults (≥18 years of age) with type 2 diabetes who previously received basal insulin and were newly initiated on iGlarLixi or basal-bolus insulin therapy. Cohorts were propensity score–matched in a 1:1 ratio on baseline characteristics, and imbalances were adjusted in multivariate analyses. Subgroup analyses were performed for people ≥65 years of age and those with a baseline A1C ≥9%. The primary end point was persistence with therapy at 12 months in the overall population. Secondary end points were treatment adherence, health care resource utilization (HCRU), costs, any hypoglycemia, and A1C change at 12 months. Results Cohorts each comprised 1,070 participants. Treatment persistence at 12 months was statistically significantly higher for iGlarLixi versus basal-bolus insulin therapy (43.7 vs. 22.3%, hazard ratio 0.51, 95% CI 0.46–0.57, adjusted P
doi_str_mv 10.2337/ds22-0064
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Rachel</creator><creatorcontrib>Pantalone, Kevin M. ; Heller, Caroline ; Lajara, Rosemarie ; Lew, Elisheva ; Li, Xuan ; Dex, Terry ; Kilpatrick, C. Rachel</creatorcontrib><description>Background When type 2 diabetes is suboptimally controlled with basal insulin, prandial insulin injections are commonly added (i.e., a basal-bolus insulin regimen), which can increase treatment burden and hypoglycemia risk. The once-daily injectable iGlarLixi is an alternative treatment. Methods This retrospective analysis of the U.S. Optum Clinformatics database compared outcomes in adults (≥18 years of age) with type 2 diabetes who previously received basal insulin and were newly initiated on iGlarLixi or basal-bolus insulin therapy. Cohorts were propensity score–matched in a 1:1 ratio on baseline characteristics, and imbalances were adjusted in multivariate analyses. Subgroup analyses were performed for people ≥65 years of age and those with a baseline A1C ≥9%. The primary end point was persistence with therapy at 12 months in the overall population. Secondary end points were treatment adherence, health care resource utilization (HCRU), costs, any hypoglycemia, and A1C change at 12 months. Results Cohorts each comprised 1,070 participants. Treatment persistence at 12 months was statistically significantly higher for iGlarLixi versus basal-bolus insulin therapy (43.7 vs. 22.3%, hazard ratio 0.51, 95% CI 0.46–0.57, adjusted P &lt;0.001). Adherence was numerically higher for iGlarLixi, and hypoglycemia events, HCRU, and costs were numerically lower for iGlarLixi. A1C reduction from baseline was slightly greater for basal-bolus insulin. Results for both subgroups (≥65 years of age and baseline A1C ≥9%) were similar to those of the overall population. Conclusion In this observational study, initiation of once-daily iGlarLixi versus basal-bolus insulin was associated with higher persistence, lower hypoglycemia, and similar A1C reduction without increasing HCRU or costs regardless of age or A1C. iGlarLixi could be an alternative to basal-bolus insulin, particularly for older adults with type 2 diabetes who require treatment simplification with lower hypoglycemia risk.</description><identifier>ISSN: 1040-9165</identifier><identifier>EISSN: 1944-7353</identifier><identifier>DOI: 10.2337/ds22-0064</identifier><language>eng</language><publisher>Alexandria: American Diabetes Association</publisher><subject>Age ; Diabetes ; Diabetes mellitus (non-insulin dependent) ; Hypoglycemia ; Insulin ; Resource utilization</subject><ispartof>Diabetes spectrum, 2023-01, Vol.36 (3), p.253-263</ispartof><rights>Copyright American Diabetes Association Summer 2023</rights><rights>2023 by the American Diabetes Association 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2964-a46e03fc016cc6194448d35838be3f593ee3ec85c739afedf75d6fb9105d72683</citedby><cites>FETCH-LOGICAL-c2964-a46e03fc016cc6194448d35838be3f593ee3ec85c739afedf75d6fb9105d72683</cites><orcidid>0000-0002-3897-4551</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425231/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425231/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,53796,53798</link.rule.ids></links><search><creatorcontrib>Pantalone, Kevin M.</creatorcontrib><creatorcontrib>Heller, Caroline</creatorcontrib><creatorcontrib>Lajara, Rosemarie</creatorcontrib><creatorcontrib>Lew, Elisheva</creatorcontrib><creatorcontrib>Li, Xuan</creatorcontrib><creatorcontrib>Dex, Terry</creatorcontrib><creatorcontrib>Kilpatrick, C. Rachel</creatorcontrib><title>Initiation of iGlarLixi Versus Basal-Bolus Insulin in Adults With Type 2 Diabetes Advancing From Basal Insulin Therapy: The SoliComplex Real-World Study</title><title>Diabetes spectrum</title><description>Background When type 2 diabetes is suboptimally controlled with basal insulin, prandial insulin injections are commonly added (i.e., a basal-bolus insulin regimen), which can increase treatment burden and hypoglycemia risk. The once-daily injectable iGlarLixi is an alternative treatment. Methods This retrospective analysis of the U.S. Optum Clinformatics database compared outcomes in adults (≥18 years of age) with type 2 diabetes who previously received basal insulin and were newly initiated on iGlarLixi or basal-bolus insulin therapy. Cohorts were propensity score–matched in a 1:1 ratio on baseline characteristics, and imbalances were adjusted in multivariate analyses. Subgroup analyses were performed for people ≥65 years of age and those with a baseline A1C ≥9%. The primary end point was persistence with therapy at 12 months in the overall population. Secondary end points were treatment adherence, health care resource utilization (HCRU), costs, any hypoglycemia, and A1C change at 12 months. Results Cohorts each comprised 1,070 participants. Treatment persistence at 12 months was statistically significantly higher for iGlarLixi versus basal-bolus insulin therapy (43.7 vs. 22.3%, hazard ratio 0.51, 95% CI 0.46–0.57, adjusted P &lt;0.001). Adherence was numerically higher for iGlarLixi, and hypoglycemia events, HCRU, and costs were numerically lower for iGlarLixi. A1C reduction from baseline was slightly greater for basal-bolus insulin. Results for both subgroups (≥65 years of age and baseline A1C ≥9%) were similar to those of the overall population. Conclusion In this observational study, initiation of once-daily iGlarLixi versus basal-bolus insulin was associated with higher persistence, lower hypoglycemia, and similar A1C reduction without increasing HCRU or costs regardless of age or A1C. iGlarLixi could be an alternative to basal-bolus insulin, particularly for older adults with type 2 diabetes who require treatment simplification with lower hypoglycemia risk.</description><subject>Age</subject><subject>Diabetes</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Hypoglycemia</subject><subject>Insulin</subject><subject>Resource utilization</subject><issn>1040-9165</issn><issn>1944-7353</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpdkd9KHDEUxodioWp70TcI9MZejObPJDPjTdFt1YWFQt3Wy5BNzriRTDImM-K-SR_XDCtCC4F8cH75zjn5iuIzwaeUsfrMJEpLjEX1rjgkbVWVNePsIGtc4bIlgn8ojlJ6wBhTQulh8Xfp7WjVaINHoUP22qm4ss8W_YGYpoQuVVKuvAwu66VPk7Me5XNhJjcmdGfHLVrvBkAUfbdqAyOkXHtSXlt_j65i6PcOb2_XW4hq2J3PAt0GZxehHxw8o1-Q-9yF6Ay6HSez-1i875RL8On1Pi5-X_1YL27K1c_r5eJiVWraiqpUlQDMOo2J0FrMG1eNYbxhzQZYx1sGwEA3XNesVR2YruZGdJuWYG5qKhp2XHzb-w7TpgejwY9ROTlE26u4k0FZ-W_F2628D08y_yjllJHscPLqEMPjBGmUvU0anFMewpQkbThpRFMLmtEv_6EPYYo-7zdTLMfGapGpr3tKx5BShO5tGoLlnLKcU5ZzyuwF3k2beA</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Pantalone, Kevin M.</creator><creator>Heller, Caroline</creator><creator>Lajara, Rosemarie</creator><creator>Lew, Elisheva</creator><creator>Li, Xuan</creator><creator>Dex, Terry</creator><creator>Kilpatrick, C. 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Rachel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2964-a46e03fc016cc6194448d35838be3f593ee3ec85c739afedf75d6fb9105d72683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age</topic><topic>Diabetes</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Hypoglycemia</topic><topic>Insulin</topic><topic>Resource utilization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pantalone, Kevin M.</creatorcontrib><creatorcontrib>Heller, Caroline</creatorcontrib><creatorcontrib>Lajara, Rosemarie</creatorcontrib><creatorcontrib>Lew, Elisheva</creatorcontrib><creatorcontrib>Li, Xuan</creatorcontrib><creatorcontrib>Dex, Terry</creatorcontrib><creatorcontrib>Kilpatrick, C. Rachel</creatorcontrib><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes spectrum</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pantalone, Kevin M.</au><au>Heller, Caroline</au><au>Lajara, Rosemarie</au><au>Lew, Elisheva</au><au>Li, Xuan</au><au>Dex, Terry</au><au>Kilpatrick, C. Rachel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Initiation of iGlarLixi Versus Basal-Bolus Insulin in Adults With Type 2 Diabetes Advancing From Basal Insulin Therapy: The SoliComplex Real-World Study</atitle><jtitle>Diabetes spectrum</jtitle><date>2023-01-01</date><risdate>2023</risdate><volume>36</volume><issue>3</issue><spage>253</spage><epage>263</epage><pages>253-263</pages><issn>1040-9165</issn><eissn>1944-7353</eissn><abstract>Background When type 2 diabetes is suboptimally controlled with basal insulin, prandial insulin injections are commonly added (i.e., a basal-bolus insulin regimen), which can increase treatment burden and hypoglycemia risk. The once-daily injectable iGlarLixi is an alternative treatment. Methods This retrospective analysis of the U.S. Optum Clinformatics database compared outcomes in adults (≥18 years of age) with type 2 diabetes who previously received basal insulin and were newly initiated on iGlarLixi or basal-bolus insulin therapy. Cohorts were propensity score–matched in a 1:1 ratio on baseline characteristics, and imbalances were adjusted in multivariate analyses. Subgroup analyses were performed for people ≥65 years of age and those with a baseline A1C ≥9%. The primary end point was persistence with therapy at 12 months in the overall population. Secondary end points were treatment adherence, health care resource utilization (HCRU), costs, any hypoglycemia, and A1C change at 12 months. Results Cohorts each comprised 1,070 participants. Treatment persistence at 12 months was statistically significantly higher for iGlarLixi versus basal-bolus insulin therapy (43.7 vs. 22.3%, hazard ratio 0.51, 95% CI 0.46–0.57, adjusted P &lt;0.001). Adherence was numerically higher for iGlarLixi, and hypoglycemia events, HCRU, and costs were numerically lower for iGlarLixi. A1C reduction from baseline was slightly greater for basal-bolus insulin. Results for both subgroups (≥65 years of age and baseline A1C ≥9%) were similar to those of the overall population. Conclusion In this observational study, initiation of once-daily iGlarLixi versus basal-bolus insulin was associated with higher persistence, lower hypoglycemia, and similar A1C reduction without increasing HCRU or costs regardless of age or A1C. iGlarLixi could be an alternative to basal-bolus insulin, particularly for older adults with type 2 diabetes who require treatment simplification with lower hypoglycemia risk.</abstract><cop>Alexandria</cop><pub>American Diabetes Association</pub><doi>10.2337/ds22-0064</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-3897-4551</orcidid><oa>free_for_read</oa></addata></record>
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subjects Age
Diabetes
Diabetes mellitus (non-insulin dependent)
Hypoglycemia
Insulin
Resource utilization
title Initiation of iGlarLixi Versus Basal-Bolus Insulin in Adults With Type 2 Diabetes Advancing From Basal Insulin Therapy: The SoliComplex Real-World Study
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