Phase 3 · Liraglutide

LixiLan-G trial results

A 26-Week Randomized, Open-label, Active Controlled, Parallel-group, Study Assessing the Efficacy and Safety of the Insulin Glargine/Lixisenatide Fixed Ratio Combination in Adults With Type 2 Diabetes Inadequately Controlled on GLP-1 Receptor Agonist and Metformin (Alone or With Pioglitazone and/or SGLT2 Inhibitors), Followed by a Fixed Ratio Combination Single-arm 26-Week Extension Period

Change From Baseline in Glycated Hemoglobin (HbA1c) to Week 26: Core Period (percentage of HbA1c), Baseline, Week 26. Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC): -1.02; GLP-1 Receptor Agonist: -0.38.

Participants
514
Status
completed
Completed
2018-11-17
Sponsor
Sanofi

As posted on ClinicalTrials.gov (NCT02787551), updated at source Mar 25, 2022. Read again whenever the registry updates it. Registry figures can differ from a published paper, which may use another analysis.

Primary outcome

What LixiLan-G measured first

Change From Baseline in Glycated Hemoglobin (HbA1c) to Week 26: Core Periodpercentage of HbA1c · Baseline, Week 26 · least squares mean
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=250GLP-1 Receptor Agonistn=253
-1.02(0.048)-0.38(0.048)
Change From Baseline in Glycated Hemoglobin (HbA1c) to Week 52: Single Arm Extension Periodpercentage of HbA1c · Baseline, Week 52 · mean
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=202
-1.01(0.063)
Side effects by arm

Side effects in LixiLan-G

Percent of participants affected, All Adverse Events (AEs) were collected from signature of informed consent until the end of the study (up to 52 weeks).. The most common events the registry lists.

EventFixed Ratio CombinationGLP-1 Receptor AgonistFixed Ratio Combination Whole Study Period
Any serious event3.9%3.5%10.2%
Nasopharyngitis9.8%9%15.5%
Nausea8.6%2.3%9.2%
Diarrhoea5.5%2.3%7.3%
Influenza4.3%2.3%7.3%
Upper Respiratory Tract Infection3.5%4.7%6.3%
Secondary outcomes

What else it measured

Percentage of Participants Reaching HbA1c <7% or <=6.5% at Week 26: Core Periodpercentage of participants · Week 26 · number
MeasureInsulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=252GLP-1 Receptor Agonistn=253
HbA1c <7%61.925.7
HbA1c <=6.5%40.59.9
Percentage of Participants Reaching HbA1c <7 % or <=6.5% at Week 52: Single Arm Extension Periodpercentage of participants · Week 52 · number
MeasureInsulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=206
HbA1c <7%64.1
HbA1c <=6.5%42.7
Change From Baseline in Fasting Plasma Glucose (FPG) to Week 26: Core Periodmillimoles per litre (mmol/L) · Baseline, Week 26 · least squares mean
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=251GLP-1 Receptor Agonistn=253
-2.28(0.120)-0.60(0.119)
Change From Baseline in Fasting Plasma Glucose (FPG) to Week 52: Single Arm Extension Periodmmol/L · Baseline, Week 52 · mean
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=196
-2.27(0.173)
Change From Baseline in the Daily Average of the 7-point Self-monitored Plasma Glucose (SMPG) to Week 26: Core Periodmmol/L · Baseline, Week 26 · least squares mean
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=216GLP-1 Receptor Agonistn=220
-1.69(0.114)-0.67(0.112)
Change From Baseline in the Daily Average of the 7-point Self-monitored Plasma Glucose (SMPG) to Week 52: Single Arm Extension Periodmmol/L · Baseline, Week 52 · mean
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=142
-1.68(0.176)
Change From Baseline in 2-Hour Postprandial Plasma Glucose (PPG) During Standardized Meal Test to Week 26: Core Periodmmol/L · Baseline, Week 26 · least squares mean
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=215GLP-1 Receptor Agonistn=222
-3.96(0.211)-1.11(0.205)
Change From Baseline in 2-Hour Postprandial Plasma Glucose (PPG) During Standardized Meal Test to Week 52: Single Arm Extension Periodmmol/L · Baseline, Week 52 · mean
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=192
-4.30(0.284)
Change From Baseline in 2-Hour Blood Glucose Excursion During Standardized Meal Test to Week 26: Core Periodmmol/L · Baseline, Week 26 · least squares mean
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=215GLP-1 Receptor Agonistn=220
-1.51(0.177)-0.52(0.173)
Change From Baseline in 2-Hour Blood Glucose Excursion During Standardized Meal Test to Week 52: Single Arm Extension Periodmmol/L · Baseline, Week 52 · mean
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=192
-1.85(0.209)
Percentage of Participants Requiring Rescue Therapy During the 26 Week Treatment Period: Core Periodpercentage of participants · From Baseline to Week 26 · number
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=252GLP-1 Receptor Agonistn=253
4.815.0
Percentage of Participants Requiring Rescue Therapy During the 52 Week Treatment Period: Single Arm Extension Periodpercentage of participants · From Week 26 to Week 52 · number
Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC)n=206
1.5
The trial

How LixiLan-G was run

Primary Objective: To demonstrate the superiority of the insulin glargine/lixisenatide fixed ratio combination (FRC) versus GLP-1 receptor agonist (GLP-1 RA) in hemoglobin A1c (HbA1c) change. Secondary Objectives: To compare the overall efficacy and safety of the insulin glargine/lixisenatide FRC to GLP-1 RA on top of metformin (with or without pioglitazone, with or without sodium-glucose co-transporter 2 \[SGLT2\] inhibitor) in participants with type 2 diabetes. To evaluate safety, efficacy and other endpoints of FRC up to the end of the extension period.

  • Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC): Core period: FRC injected subcutaneously once daily (QD) for 26 weeks on top of oral anti-diabetic drug (OAD) therapy. Dose individually adjusted. Single arm extension period: Participants who completed core treatment period and met eligibility criteria entered in extension treatment period and received same treatment (FRC injected subcutaneously QD on top of OAD therapy) for 26 weeks (up to Week 52). Dose individually adjusted.
  • GLP-1 Receptor Agonist: Core period: GLP-1 RA receptor agonist (liraglutide QD, exenatide twice daily \[BID\], exenatide extended-release QW, albiglutide QW, or dulaglutide QW) injected subcutaneously for 26 weeks on top of OAD therapy. GLP-1 RAs were administered as per local labeling at the same dose schedule as prior to randomization.
Who could join the trial

Inclusion criteria : * Participants with type 2 diabetes mellitus diagnosed at least 1 year prior to screening visit. * Participants who were treated with one of the following GLP-1 receptor agonists for at least 4 months prior to screening visit 1 (V1), and with stable dose for at least 3 months prior to screening visit (V1): * Liraglutide (Victoza®) 1.8 milligram (mg) QD or 1.2 mg QD, if the 1.8 mg QD dose was not well tolerated according to the Investigator's judgment or * Exenatide (Byetta®) 10 microgram (µg) BID or of 5 µg BID, if 10 µg BID dose was not well tolerated according to the Investigator's judgment in combination with metformin (daily dose greater than equal to \[\>=\] 1500 mg/day or maximum tolerated dose \[MTD\]), with or without pioglitazone, with or without SGLT2 inhibitor, all at stable dose for at least 3 months prior to screening. or Participants who were treated with stable dose of one of the following GLP-1 receptor agonists for at least 6 months prior to screening visit (V1): * Exenatide extended-release (Bydureon®) 2 mg once weekly (QW), if well tolerated according to Investigator's judgment, * Albiglutide (Tanzeum®) 50 mg QW or 30 mg QW, if 50 mg QW was not well tolerated according to Investigator's judgment, * Dulaglutide (Trulicity®) 1.5 mg QW or 0.75 mg QW, if 1.5 mg QW was not well tolerated according to Investigator's judgment in combination with metformin (daily dose ≥1500 mg/day or MTD), with or without pioglitazone, with or without SGLT2 inhibitor, all at stable dose for at least 3 months prior to screening; -Signed written informed consent. Exclusion criteria: * At screening visit, age \<18. * Screening HbA1c \<7% and \>9%. * Pregnancy or lactation, women of childbearing potential with no effective contraceptive method. * Any use of antidiabetic drugs within 3 months prior to the screening visit other than those described in the inclusion criteria. * Previous treatment with insulin in the year prior to screening visit (note: short-term treatment with insulin \[\<=10 days\] due to intercurrent illness including gestational diabetes was allowed at the discretion of the study physician). * Laboratory findings at the time of screening, including: * Fasting plasma glucose (FPG) \>250 mg/dL (13.9 millimoles per litre \[mmol/L\]), * Amylase and/or lipase \>3 times the upper limit of the normal laboratory range (ULN), * Alanine transaminase or aspartate transaminase \>3 ULN, * Calcitonin \>=20 pg/mL (5.9 pmol/L), * Positive pregnancy test. * Participant who had renal function impairment with estimated glomerular filtration rate \<30mL/min/1.73m\^2 (using the Modification of Diet in Renal Disease formula) or end-stage renal disease. * Contraindication to use of insulin glargine, or lixisenatide or GLP-1 receptor agonist (Victoza®, Byetta®, Bydureon®, Tanzeum® or Trulicity®) according to local labeling. * Any contraindication to metformin or pioglitazone or SGLT2 inhibitor use, according to local labeling. *...

Published papers

Papers from LixiLan-G

Trial averages do not predict what one person will experience. Results are shown as the registry posts them, without interpretation.

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