Efficacy and safety of iGlarLixi versus insulin glargine in type 2 diabetes: a meta-analysis of randomized controlled trials.

Abstract

Objective: This meta-analysis aimed to compare the efficacy and safety of iGlarLixi with those of insulin glargine for treating type 2 diabetes (T2D).

Methods: A systematic search of PubMed, the Cochrane Library, and EMBASE was conducted to identify randomized controlled trials (RCTs) that compared the use of iGlarLixi with the use of insulin glargine in patients with T2D. The meta-analysis protocol was registered at PROSPERO. The primary outcomes of interest were changes in hemoglobin A1c (HbA1c) and body weight. Risk ratios and mean differences with 95% confidence intervals were calculated using random-effects models.

Results: We included 7 RCTs comprising 2229 men and 1926 women, of whom 2075 (49.94%) were randomized to iGlarLixi. Compared with insulin glargine, iGlarLixi decreased HbA1c (MD: -0.50%; 95% CI: -0.65% to -0.35%; p < 0.00001) and body weight (MD: -1.17 kg; 95% CI: -1.36 kg to -0.98 kg; p < 0.00001) and self-measured plasma glucose (MD: -0.97 mmol/L; 95% CI: -1.27 mmol/L to -0.68 mmol/L; p < 0.00001) and increased the percentage of patients achieving HbA1c < 7% (RR: 1.66; 95% CI: 1.31 to 2.11; p < 0.0001), the percentage of patients achieving HbA1c < 6.5% (RR: 2.11; 95% CI: 1.53 to 2.92; p < 0.00001), and HbA1c < 7.0% without weight gain and/or without severe or blood glucose-confirmed hypoglycemic episodes (RR: 2.18; 95% CI: 1.76 to 2.69; p < 0.00001). However, a higher incidence of gastrointestinal adverse events (RR: 2.02; 95% CI: 1.61 to 2.54; p < 0.00001) and adverse events (RR: 1.08; 95% CI: 1.02 to 1.14; p = 0.008) was associated with iGlarLixi than with insulin glargine.

Conclusions: Compared with insulin glargine, iGlarLixi is superior in reducing blood glucose levels and facilitating weight loss. Nevertheless, its administration is also linked to a heightened occurrence of gastrointestinal and adverse events.