Efficacy and safety of ideglira in older patients with type 2 diabetes

Objective: The efficacy and safety of insulin degludec/ liraglutide (IDegLira) in older patients has not yet been reported. This analysis aimed to evaluate the efficacy and safety of IDegLira in patients aged ≥65 years. Methods: A post hoc analysis compared results of patients aged ≥65 versus <;65 years from DUAL II, III, and V. These were 26-week, phase 3, randomized, two-arm parallel, treat-to-target trials in patients already taking injectable glucose-lowering agents. We evaluated 311 patients aged <;65 and 87 patients aged ≥65 years from DUAL II, 326 patients <;65 years and 112 patients ≥65 years from DUAL III, and 412 patients <;65 years and 145 patients ≥65 years from DUAL V. Patients were randomized to IDegLira or insulin degludec (DUAL II), IDegLira or unchanged glucagon-like peptide 1-receptor agonist (GLP-1RA) (DUAL III), or IDegLira or IGlar U100 (DUAL V). Results: In patients ≥65 years, hemoglobin A1C decreased to a greater extent with IDegLira than with comparators (estimated treatment differences, −1.0% [−1.5; −0.6]_95% confidence interval [CI], −0.8% [−1.0; −0.5]_95% CI, and −0.9% [−1.3; −0.6]_95%CI) for DUAL II, V, and III, respectively; all P<;.001). These mirrored results of patients <;65 years of age. Hypoglycemia rates were lower with IDegLira versus basal insulin and higher versus unchanged GLP-1RA (estimated rate ratios, 0.5 [0.2; 1.6]_{95% CI} [P = .242]; 0.3 [0.1; 0.5]_{95% CI} [P<;.001], and 11.8 [3.3; 42.8]_{95% CI} [P<;.001] for DUAL II, V, and III, respectively). Conclusion: Patients aged ≥65 years on basal insulin or GLP-1RA can improve glycemic control with IDegLira, and it is well tolerated overall.