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  • Novel Fixed Ratio...

Novel Fixed Ratio Combination therapy promising for T2D patients, research shows

Dr Kartikeya KohliWritten by Dr Kartikeya Kohli Published On 2021-11-06T09:00:36+05:30  |  Updated On 6 Nov 2021 10:36 AM IST
Novel Fixed Ratio Combination therapy promising for T2D patients, research shows
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Fixed Ratio Combination (FRC) therapy could arise as a valid therapeutic option for the insulin-treated patients that need further intensification, according to a new study.

Type 2 Diabetes (T2D), also called as Adult Onset Diabetes, has emerged as a major global health concern over the past few decades. It is a chronic condition that affects the way the body processes blood sugar (glucose).

With type 2 diabetes, the body either doesn't produce enough insulin, or it resists insulin.
Symptoms include increased thirst, frequent urination, hunger, fatigue and blurred vision. In some cases, there may be no symptoms. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are often prescribed along with metformin for patients with Type 2 Diabetes.
However, approximately 40-60% of people with T2D do not reach their glycemic target, and that resistance to intensification occurs when initiating or titrating basal insulin. To counter this, a team of researchers from Italy, led by Riccardo Candido, proposed the novel approach to treating type 2 diabetes: Fixed Ratio Combination (FRC) therapy.
They evaluated the impact of an FRC, iGlarLixi, in a retrospective, multi-center study, based on electronic medical records. iGlarLixi is a once-daily FRC of basal insulin glargine (100 U/mL) and GLP1-RA lixisenatide. All subjects initiating iGlarLixi in May 2018-July 2020 were analyzed. Overall, 25 centers provided data on 675 subjects between 55-75 years of age. Before starting iGlarLixi, 67.3% of subjects were treated with BI and 9.9% with GLP1-RA. Drugs associated with iGlarLixi were not only metformin and SGLT2 inhibitors, as by summary of product characteristics (SmPC); off-label combinations were found in 32.4% of patients
The results showed:
i) HbA1c decreased by -0.77% [95%CI -1.00;-0.54] after 6 months and by -0.92% [95%CI -1.22;-0.62] in patients treated as by SmPC (Summary of product characteristics).
ii) Weight significantly decreased by 1.21 Kg.
iii) Rates of blood glucose ≤70 and <54 mg/ml (N=171) were 0.26 and 0.05 events per person-month, respectively
iv) No severe hypoglycemic events occurred.
However, many patients did not discontinue their previous therapies after the 6-month trial. Investigators attributed this decision to a lack of data in appropriateness and dose intensification, which they hoped would be addressed in future studies.
"iGlarLixi could arise as a valid therapeutic option for the insulin-treated patients that need further intensification, having residual hyperglycemia and/or still lack in titrating basal insulin, based on its effectiveness, reduced risk of hypoglycemia and flexibility of administration," the team concluded.
Reference:
Study titled, "110-LB: Efficacy, Safety, and Appropriateness of iGlarLixi, a Fixed-Ratio Combination (FRC) in Type 2 Diabetes (T2D) in Real-World Settings: Results from the ENSURE Study," as published by American Diabetes Association.
DOI: 10.2337/db21-110-LB


ADAT2DMFixed ratio combination therapyDiabetes
Dr Kartikeya Kohli
Dr Kartikeya Kohli

    Dr Kartikeya Kohli is an Internal Medicine Consultant at Sitaram Bhartia Hospital in Delhi with super speciality training in Nephrology. He has worked with various eminent hospitals like Indraprastha Apollo Hospital, Sir Gangaram Hospital. He holds an MBBS from Kasturba Medical College Manipal, DNB Internal Medicine, Post Graduate Diploma in Clinical Research and Business Development, Fellow DNB Nephrology, MRCP and ECFMG Certification. He has been closely associated with India Medical Association South Delhi Branch and Delhi Medical Association and has been organising continuing medical education programs on their behalf from time to time. Further he has been contributing medical articles for their newsletters as well. He is also associated with electronic media and TV for conduction and presentation of health programs. He has been associated with Medical Dialogues for last 3 years and contributing articles on regular basis.

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