Once-Weekly Efsitora Matches Daily Degludec in HbA1c Reduction, finds study
In insulin-naïve Japanese patients, once-weekly efsitora was as effective and safe as once-daily degludec in lowering HbA1c, with results consistent with the overall QWINT-2 study population. The study was published in the journal of Diabetes Therapy by Kiyosue A. and colleagues.
In order to determine the effectiveness of the treatment intervention in this specific region, researchers obtained data collected from Japanese participants of the international multicenter study known as QWINT-2. The particular study targeted insulin-naïve adults who had poorly controlled type 2 diabetes on other non-insulin glucose lowering drugs. Specifically, Japanese patients were randomized in a one-to-one ratio to either the weekly regimen or the daily regimen of the insulin degludec treatment program for a period of 52 weeks. The important feature of this study involved utilizing two different insulin initiation and titration approaches driven by algorithms that would target East Asian body habitus characteristics.
The participants were allocated into a general dosing approach or an alternative dosing approach that was expected to target people who were likely to be insulin-sparing. Eligible for the alternative dosing approach included those with body weight below 60kg or HbA1c below 7.5%. Important clinical outcomes were changes in HbA1c and fasting blood glucose from baseline to 52 weeks, time-in-range (TIR) measured between weeks 48 and 52, and hypoglycemia events.
Key findings:
- For the localized analysis, 144 randomized patients from Japan were involved in the study, where 71 patients were allocated to the once-weekly injection of efsitora and 73 to the once-daily injection of degludec.
- During the period from week 0 up to week 52, the mean value of HbA1c in the efsitora group fell from 8.04% to 6.63%, whereas in the degludec group – from 8.00% to 6.64%.
- Consequently, the estimated treatment difference between the two groups amounted to only −0.01%.
- Continuous glucose monitoring for the weeks 48 to 52 proved that the time in the target range (TIR) was almost identical between the efsitora and degludec groups.
- The rate of combined level 2 and 3 hypoglycemia events stayed relatively low for the whole period of 52 weeks, as well as in the period of 0-to-12-week titration.
- No severe hypoglycemia episodes (level 3 hypoglycemia) were recorded among patients with efsitora injections; on the contrary, two participants in the degludec group developed such events.
- The effectiveness and safety profiles of efsitora treatment turned out to be quite similar to those of degludec irrespective of the algorithm chosen.
Conclusively, weekly administration of efsitora proved to be equivalent to once-a-day administration of degludec in terms of decreasing HbA1c levels among Japanese subjects. The safety and efficacy profile of efsitora among the Japanese subjects was similar to that among the entire cohort of subjects in the QWINT-2 study. This precise information is reassuring to clinicians trying to simplify diabetes management in East Asia.
Reference:
Kiyosue, Arihiro, et al. "Efficacy and Safety of Insulin Efsitora Versus Degludec in Adults With Type 2 Diabetes Who Are Insulin-Naïve: Japan Subgroup Analysis of QWINT-2." Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders, vol. 17, no. 5, 2026, pp. 771-785.
