1867-LB: A Real-World Study Assessing the Efficacy and Safety of Switching from Basal–Bolus Insulin Therapy to Once-Daily iGlarLixi in People with Type 2 Diabetes—Soli De-escalation
Authors: GIORGINO FRANCESCO , LAUAND FELIPE , SERVERA SORALY , LI XUAN , TAYBANI ZOLTÁN , CHENG ALICE Y.Y. , FONSECA VIVIAN , TEBAIBIA AMAR , ANAFOROGLU INAN 
Published: June 2024

Introduction and Objective: Basal bolus insulin (BBI) therapy is associated with body weight (BW) gain and an increased risk of hypoglycemia, further increasing the treatment burden for people with T2D. This real-world study assessed the efficacy and safety of switching from BBI to iGlarLixi, a once-daily fixed-ratio combination of insulin glargine 100 U/mL plus lixisenatide, in people with T2D.
Methods: This real-world retrospective study included people with T2D (≥18 years) who received ≥1 iGlarLixi prescription during the identification (ID) period following prior treatment with BBI using the Optum Market Clarity® electronic medical record dataset of people with T2D from the United States. The primary endpoint was HbA1c change at 6 months. Secondary endpoints were HbA1c change at 3 months, BW change and hypoglycemic event rate at 6 months.
Results: In total, 11,887 people received ≥1 iGlarLixi prescription during the ID period, and of these, 372 had switched from a BBI regimen to iGlarLixi (mean age, 59 years; mean baseline HbA1c, 9.55%; mean baseline BW, 101.9 kg). From baseline to Month 6, switching to iGlarLixi resulted in a significant mean HbA1c reduction of −0.93% (95% confidence interval [CI]: −1.13, −0.74; p&lt;0.0001) to 8.61% (n=372). At Month 3, HbA1c was 8.68% (n=204). The mean change in BW at 6 months was −0.89 kg (95% CI: −1.61, −0.18; n=359). The hypoglycemia event rate was 46.24 per 100 person-years of follow-up (P100PYFU) at baseline and 40.32 P100PYFU (event rate ratio: 0.77; 95% CI: 0.57, 1.05) after 6 months of iGlarLixi treatment.
Conclusion: In a real-world setting, people with T2D and elevated HbA1c switching from a BBI regimen to a once-daily injection of iGlarLixi achieved lower HbA1c, weight benefit and numerically lower hypoglycemic events.

Disclosure
F. Giorgino: Consultant; AstraZeneca, Boehringer-Ingelheim, Eli Lilly and Company, LifeScan Diabetes Institute, Merck Sharp & Dohme Corp., Medtronic, Novo Nordisk, Roche Diabetes Care, Sanofi. Research Support; Eli Lilly and Company, Roche Diabetes Care. F. Lauand: Employee; Sanofi. Stock/Shareholder; Sanofi. S. Servera: Employee; Sanofi. X. Li: Employee; Sanofi. Z. Taybani: Advisory Panel; Boehringer-Ingelheim. Consultant; Novo Nordisk, AstraZeneca. Speaker's Bureau; Sanofi. A.Y.Y. Cheng: Advisory Panel; Abbott. Speaker's Bureau; Amgen Inc., AstraZeneca, Bausch Health. Advisory Panel; Bayer Inc. Speaker's Bureau; Abbott, Bayer Inc. Research Support; Applied Therapeutics Inc. Advisory Panel; Boehringer-Ingelheim. Speaker's Bureau; Boehringer-Ingelheim, Dexcom, Inc. Advisory Panel; Dexcom, Inc., Eli Lilly and Company. Speaker's Bureau; Eli Lilly and Company. Advisory Panel; Eisai Inc. Speaker's Bureau; GlaxoSmithKline plc. Advisory Panel; HLS Therapeutics Inc. Speaker's Bureau; HLS Therapeutics Inc., Insulet Corporation. Advisory Panel; Insulet Corporation, Janssen Pharmaceuticals, Inc. Speaker's Bureau; Janssen Pharmaceuticals, Inc., Medtronic. Advisory Panel; Novo Nordisk. Speaker's Bureau; Novo Nordisk. Research Support; Novo Nordisk. Speaker's Bureau; Pfizer Inc. Advisory Panel; Sanofi. Speaker's Bureau; Sanofi. Research Support; Sanofi. Advisory Panel; Takeda Canada, AstraZeneca, Sanofi. Consultant; Abbott, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Dexcom, Inc., Eisai Inc., Eli Lilly and Company, Insulet Corporation, HLS Therapeutics Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk, Sanofi, Takeda Pharmaceutical Company Limited. V. Fonseca: Consultant; Abbott, Bayer Inc. Stock/Shareholder; BRAVO4HEALTH, LLC. Consultant; Corcept Therapeutics. Speaker's Bureau; Eli Lilly and Company. Research Support; Fractyl Health, Inc. Consultant; Sun Pharmaceutical Industries Ltd. Stock/Shareholder; Amgen Inc. A. Tebaibia: None. I. Anaforoglu: None.

Funding
Sanofi