Once-Weekly Insulin Efsitora Achieves Comparable A1C Reduction to Daily Insulin Therapy
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~ A new study has found that once-weekly insulin efsitora alfa (efsitora) is just as effective as daily basal insulin in lowering blood glucose levels in people with type 2 diabetes. The results of the QWINT-1 study were presented at the 85th Scientific Sessions of the American Diabetes Association® (ADA) in Chicago and published simultaneously in The New England Journal of Medicine.

The study, which was the first of its kind, aimed to address the growing need for simpler options for insulin therapy. According to the findings, one in four people with type 2 diabetes do not take their prescribed dosage of basal insulin correctly due to the burden of daily injections and frequent dose adjustments. This can lead to dangerous high blood glucose levels and long-term organ damage.

QWINT-1 was a Phase 3, open-label, randomized study that evaluated the efficacy and safety of a fixed-dose titration of once-weekly insulin efsitora in 795 adults with type 2 diabetes who were taking basal insulin for the first time. The study compared efsitora to once-daily insulin glargine, with the goal of determining whether a fixed-dose, once-weekly regimen could offer comparable blood glucose management while reducing the burden of starting and managing insulin therapy. Efsitora was titrated to four fixed doses at four-week intervals as needed for blood glucose management.

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After 52 weeks, the study showed that efsitora lowered A1C levels by 1.31%, reaching an average A1C of 6.92%, compared to a reduction of 1.27% and an A1C of 6.96% with insulin glargine. A second analysis based on how well patients followed their treatment also showed similar results: efsitora reduced A1C by 1.19% (to 7.05%) compared to a reduction of 1.16% (to 7.08%) with glargine.

Lead investigator of the QWINT-1 trial, Dr. Julio Rosenstock, senior scientific advisor at Medical City Dallas and clinical professor of medicine at the University of Texas Southwestern Medical Center, stated that these results confirm the effectiveness of once-weekly insulin efsitora in controlling blood sugar levels while also offering the benefit of a simpler dosing schedule. He also noted that the novel fixed-dose regimen used in the study has the potential to ease the burden of starting insulin therapy for both patients and providers, potentially improving adherence and long-term health outcomes.

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In light of these findings, Lilly has announced plans to submit efsitora for the treatment of type 2 diabetes to global regulatory authorities by the end of 2025.

The results of this study were presented by Dr. Rosenstock at a symposium titled "Advancing and Facilitating Basal Insulin Therapy in Type 2 Diabetes—Breaking News on the QWINT 1, 3, and 4 Trials with Once-Weekly Insulin Efsitora Alfa!" on Sunday, June 22 at 2:20 p.m. CT. The presentation focused on the efficacy and safety of efsitora as a weekly basal insulin using a novel fixed-dose escalation compared to insulin glargine in insulin-naïve participants with type 2 diabetes.

This groundbreaking study offers hope for people with type 2 diabetes who struggle with daily injections and dose adjustments for basal insulin therapy. With once-weekly insulin efsitora showing comparable results to daily basal insulin, it has the potential to simplify treatment and improve long-term health outcomes for patients.

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