Efsitora: Weekly Insulin Shows Promise in Type 2 Diabetes Management
Table of Contents
- Efsitora: Weekly Insulin Shows Promise in Type 2 Diabetes Management
CHICAGO – A novel, once-weekly basal insulin analog called efsitora alfa has demonstrated comparable efficacy to daily basal insulins in lowering A1c levels among individuals with type 2 diabetes (T2D). Data presented at the American Diabetes Association (ADA) 85th Scientific Sessions and published in the New England Journal of Medicine and The Lancet, highlight efsitora’s potential to simplify insulin therapy for T2D patients.
QWINT Trial Results: Efsitora’s Efficacy and Safety
The QWINT program, comprising multiple clinical trials, evaluated efsitora’s effectiveness and safety across various T2D patient populations. Three key trials, QWINT-1, QWINT-3, and QWINT-4, focused on different aspects of insulin therapy and patient profiles.
QWINT-1: Simplifying Insulin Initiation
QWINT-1, an open-label trial involving 795 insulin-naive adults with T2D, compared weekly efsitora to daily insulin glargine. The efsitora group followed a fixed-dose regimen with four titration levels over 52 weeks. Results showed that efsitora reduced A1c from 8.20% to 7.05%, while glargine reduced A1c from 8.28% to 7.08%,confirming noninferiority. The rate of clinically significant hypoglycemia was also lower with efsitora (0.50 events per participant-year) compared to glargine (0.88 events per participant-year) 1.
Did You Know? The global prevalence of diabetes is estimated to be 10.5% (537 million people) in 2021, and is projected to rise to 12.2% (783 million) by 2045 2.
QWINT-3 and QWINT-4: Efsitora in Combination Therapy
QWINT-3 involved 986 adults with T2D already on basal insulin and other noninsulin glucose-lowering medications. Participants were randomized to weekly efsitora or daily insulin degludec. At week 26, A1c decreased by 0.81 percentage points with efsitora versus 0.72 with degludec, meeting noninferiority criteria 3.QWINT-4 included 730 participants with T2D treated with both basal and prandial insulin, plus up to three noninsulin glucose-lowering agents. Efsitora was compared to insulin glargine U100, both used with premeal insulin lispro. At 26 weeks, mean A1c was 7.17% in the efsitora group and 7.18% in the glargine group, again demonstrating noninferiority 4.
Pro Tip: Regular monitoring of blood glucose levels and adherence to prescribed medication regimens are crucial for effective diabetes management.
Hypoglycemia Concerns and Future Implications
While moderate/severe hypoglycemia rates were similar between efsitora and comparator groups in QWINT-3 and QWINT-4, mild hypoglycemia was more frequent with efsitora. This aligns with findings from QWINT-5 (in type 1 diabetes), where hypoglycemia was a significant concern. Experts emphasize the need for careful monitoring due to efsitora’s long half-life (17 days). Continuous glucose monitoring (CGM) could help mitigate this risk, even though its use was limited in these trials.
Another once-weekly insulin,insulin Icodec (Awiqli),has been approved in several countries,but the FDA has requested more data regarding hypoglycemia risks. The cost, convenience, and individual patient preferences will ultimately determine the adoption of once-weekly insulins like efsitora. The emergence of GLP-1 receptor agonists, which also promote weight loss, may offer a competing treatment option for some patients with T2D.
Summary of QWINT Trial Results
| Trial | Patient Population | Comparison | A1c Reduction | Hypoglycemia |
|---|---|---|---|---|
| QWINT-1 | Insulin-naive T2D | Efsitora vs. Glargine | Noninferior | Lower clinically significant hypoglycemia with Efsitora |
| QWINT-3 | T2D on basal insulin + other meds | Efsitora vs. Degludec | Noninferior | Similar moderate/severe, more mild hypoglycemia with Efsitora |
| QWINT-4 | T2D on basal/prandial insulin + other meds | Efsitora vs. Glargine U100 | Noninferior | Similar moderate/severe, more mild hypoglycemia with Efsitora |
Despite potential challenges, the advancement of longer-acting insulins like efsitora represents a significant advancement in diabetes care, offering new possibilities for improved glycemic control.
What are your thoughts on the potential benefits and risks of once-weekly insulin for managing type 2 diabetes? How do you think this will impact patient adherence and overall diabetes care?
Evergreen Insights: The Evolution of Insulin Therapy
The history of insulin therapy has seen remarkable advancements, from the initial extraction of insulin from animal pancreases in the early 20th century to the development of recombinant human insulin and insulin analogs. These innovations have substantially improved the lives of people with diabetes,offering more effective and convenient ways to manage thier blood glucose levels.The introduction of once-weekly insulin analogs like efsitora represents the latest chapter in this ongoing evolution, promising to further simplify treatment regimens and enhance patient adherence.
Frequently Asked Questions About Efsitora and Weekly Insulin
Disclaimer: This article provides information for general knowledge and informational purposes only, and does not constitute medical advice. It is indeed essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
Share this article and join the conversation! What are your thoughts on the future of insulin therapy? Subscribe to our newsletter for more updates on diabetes research and treatment.
