title: Fixed-ratio combination therapy with GLP-1 receptor agonist liraglutide and insulin degludec in people with type 2 diabetes.
abstract: A fixed combination of basal insulin degludec and glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide (IDegLira; 50 units degludec/1.8 mg liraglutide) has been developed as a once daily injection for the treatment of type 2 diabetes (T2D). In the phase 3a trial programme 'Dual action of liraglutide and insulin degludec in type 2 diabetes' (DUAL™), five trials of 26 weeks duration and one trial of 32 weeks duration have evaluated the efficacy and safety of IDegLira compared with administration of insulin degludec, insulin glargine, liraglutide alone or placebo. Areas covered: Combination therapy with IDegLira reduces HbA1c more than monotherapy with a GLP-1RA (liraglutide) or insulin (degludec or glargine). Combination therapy leads also to weight loss, or a stable body weight, with no increase in hypoglycaemia. Rates of adverse events did not differ between treatment groups; however, gastrointestinal side effects were fewer with IDegLira compared with liraglutide treatment alone. A limitation of the DUAL™ development programme is that patients receiving basal insulin doses in excess of 50 units were excluded from the studies. Expert commentary: In conclusion, IDegLira combines the clinical advantages of basal insulin and GLP-1RA treatment, and is a treatment strategy that could improve the management of patients with T2D.
authors.affiliation: a Department of Endocrinology, Hvidovre Hospital and Steno Diabetes Center , University of Copenhagen , Copenhagen , Denmark.
authors.forename: Lauge
authors.initials: L
authors.lastname: Østergaard
authors.affiliation: a Department of Endocrinology, Hvidovre Hospital and Steno Diabetes Center , University of Copenhagen , Copenhagen , Denmark.
authors.forename: Christian Seerup
authors.initials: CS
authors.lastname: Frandsen
authors.affiliation: a Department of Endocrinology, Hvidovre Hospital and Steno Diabetes Center , University of Copenhagen , Copenhagen , Denmark.
authors.forename: Thomas Fremming
authors.initials: TF
authors.lastname: Dejgaard
authors.affiliation: a Department of Endocrinology, Hvidovre Hospital and Steno Diabetes Center , University of Copenhagen , Copenhagen , Denmark.
authors.forename: Sten
authors.initials: S
authors.lastname: Madsbad
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004338:Drug Combinations; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D049528:Insulin, Long-Acting / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000069450:Liraglutide / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D015431:Weight Loss / Q000187:drug effects; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D004338:Drug Combinations; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D000069450:Liraglutide; D000097789:Glucagon-Like Peptide-1 Receptor Agonists; C000613158:IDegLira
keywords: DUAL; Degludec; GLP-1 receptor agonist; glargine; liraglutide; type 2 diabetes