Insulin glargine plus lixisenatide improves outcomes in Chinese adults with T2D

Treatment with iGlarLixi* resulted in better clinical outcomes than IDegAsp** in Chinese adults with type 2 diabetes (T2D), regardless of age or disease duration at baseline, according to a post hoc analysis of the phase III Soli-D study presented at ATTD-ASIA 2025.

The Soli-D study included 582 Chinese individuals with T2D suboptimally controlled with oral antidiabetic drugs (OADs). Participants were randomized in a 1:1 ratio to receive either once-daily iGlarLixi or IDegAsp (n=291 in each group; mean age 56.3 and 57.5 years, respectively) for 24 weeks.

In this post hoc analysis, participants were assessed according to their baseline age (<65 and ≥65 years) and T2D duration (<10 and ≥10 years). [Zhang E, et al, ATTD-Asia 2025]

At week 24, individuals treated with iGlarLixi achieved greater reductions in HbA_1c compared with those receiving IDegAsp across both age groups (<65 years: -1.94 percent vs -1.69 percent; ≥65 years: -1.71 percent vs -1.66 percent) and duration of T2D (<10 years: -1.91 percent vs -1.77 percent; ≥10 years: -1.83 percent vs -1.54 percent).

Additionally, the proportion of patients who achieved the HbA_1c target of 7 percent was higher in the iGlarLixi arm than the IDegAsp arm, irrespective of baseline age (<65 years: 74.8 percent vs 60.6 percent; ≥65 years: 64.6 percent vs 57.3 percent) or disease duration (<10 years: 72.8 percent vs 66.99 percent ≥10 years: 72 percent vs 49.1 percent).

The iGlarLixi group also demonstrated numerically greater reductions in average 7-point self-monitored plasma glucose (SMPG) compared with the IDegAsp group in both age categories (<65 years: -3.8 vs -2.9 mmol/L; ≥65 years: -3.1 vs -2.6 mmol/L) and T2D duration (<10 years: -3.7 vs -2.8 mmol/L; ≥10 years: -3.5 vs -2.9 mmol/L).

Fasting plasma glucose levels were comparable between the iGlarLixi and IDegAsp in both younger and older cohorts (mean differences of 0.24 and 0.30 mmol/L, respectively) and among those with shorter or longer disease durations (mean differences of 0.29 and 0.19 mmol/L, respectively).

Mean body weight decreased by 0.14 kg (younger cohort) and 0.38 kg (older cohort) in the iGlarLixi arm, whereas it increased by 1.40 and 0.95 kg, respectively, in the IDegAsp arm. This trend was consistent among individuals with T2D durations of <10 or ≥10 years, with decreases of 0.11 and 0.35 kg, respectively, in the iGlarLixi arm and increases of 1.17 and 1.46 kg in the IDegAsp arm.

A lower total daily insulin dose was observed with iGlarLixi than with IDegAsp in both age (<65 years: 29.5 vs 35.8 U; ≥65 years: 23.6 vs 29.1 U) and disease duration subgroups (<10 years: 28.8 vs 35 U; ≥10 years: 27 vs 32.7 U).

The risk of hypoglycaemia was lower in the iGlarLixi arm vs the IDegAsp arm (relative risk [RR], 0.74 and 0.66 for those aged <65 and ≥65 years and 0.67 and 0.79 for those with <10- and ≥10-year T2D duration).

Overall, iGlarLixi showed better clinical outcomes, including greater reductions in HbA_1c and SMPG levels, a higher proportion of patients reaching the target HbA_1c of <7 percent, and reduced body weight, as well as lower total insulin doses and fewer hypoglycaemia events across both baseline age and disease duration subgroups, compared with IDegAsp, according to Dr Maria Aileen Mabunay from Sanofi in Singapore, who presented the study on behalf of the investigators.

"Therefore, iGlarLixi could be considered as one of the valuable options for advancing therapy in people in China with T2D, suboptimally controlled on OADs," she added.