Once-weekly icodec affords greater blood sugar reduction than once-daily degludec in T2D

In the treatment of individuals with insulin-naïve type 2 diabetes (T2D), once-weekly icodec yields superior HbA1c reduction compared with once-daily degludec, according to the results of a phase IIIa trial.

For the trial, a total of 588 adult participants (mean age 58 years, 37 percent women) were randomly assigned to receive either once-weekly icodec and once-daily placebo (icodec group; n=294) or once-daily degludec and once-weekly placebo (degludec group; n=294).

The primary endpoint of change in HbA1c from baseline to week 26 was greater in the icodec group than in the degludec group, with the estimated treatment difference of −0.2 percentage points (95 percent confidence interval [CI], −0.3 to −0.1) establishing the noninferiority (p<0.001) and superiority (p=0.002) of icodec to degludec.

No significant between-group difference was seen in secondary endpoints including change in fasting plasma glucose from baseline to week 26 (p=0.90), mean weekly insulin dose during the last 2 weeks of treatment, and body weight change from baseline to week 26 (p=0.17).

Meanwhile, the frequency of combined level 2 (clinically significant; glucose level <54 mg/dL) and level 3 (severe; requiring external assistance for recovery) hypoglycaemic episodes was numerically higher in the icodec than in the degludec group from weeks 0–31 (0.31 vs 0.15 events per patient-year exposure; p=0.11) and significantly higher in the icodec group from weeks 0–26 (0.35 vs 0.12 events per patient-year exposure; p=0.01).