What question did this study set out to answer?

This analysis aimed to evaluate the efficacy and safety of efsitora compared to daily insulin based on GLP-1 RA usage in patients with type 2 diabetes.

June 7, 2026

1746-P: Post Hoc Analysis of Efficacy and Safety Outcomes of Efsitora vs. Once-Daily Insulin in Type 2 Diabetes by GLP-1RA Use across QWINT-1–4 Trials

Key Points

This analysis aimed to evaluate the efficacy and safety of efsitora compared to daily insulin based on GLP-1 RA usage in patients with type 2 diabetes.
Subgroup analysis from Phase 3 QWINT-1-4 trials comparing changes in HbA1c, body weight, and hypoglycemia rates.
Evaluated baseline users and non-users of GLP-1 RA in both efsitora and insulin groups.
Focused on changes in HbA1c, body weight, fasting self-monitored blood glucose, weekly insulin doses, and hypoglycemia rates.
Efsitora showed non-inferior HbA1c reduction compared to daily insulin, irrespective of GLP-1 RA usage.
No significant differences in hypoglycemia rates or insulin doses between efsitora and daily insulin in GLP-1 RA users vs non-users.
Body weight changes varied only in trial QWINT-3 with no notable differences in other trials.

Abstract

Introduction and Objective: The Phase 3 QWINT-1-4 trials demonstrated non-inferior glycated hemoglobin A1c (HbA1c) reduction with comparable rates of hypoglycemia for insulin efsitora alfa (efsitora) versus once-daily basal insulin comparators in adults living with type 2 diabetes (T2D). This subgroup analysis examined outcomes for efsitora and once-daily comparators by baseline use of glucagon-like peptide-1 receptor agonist (GLP-1 RA) in QWINT-1-4. Methods: Change from baseline to end of trial in HbA1c, body weight (BW), fasting self-monitored blood glucose (SMBG), weekly insulin doses, and hypoglycemia rates were compared between baseline GLP-1 RA users and non-users in efsitora and once-daily comparator groups from QWINT-1 through QWINT-4 trials. Results: Across trials, for changes in HbA1c and BW, effects of efsitora relative to the once-daily comparators did not differ depending on GLP use, except for BW in QWINT-3 (Figure 1). The effects of efsitora relative to the once-daily comparators did not show any significant difference depending on GLP-1 RA use in terms of changes in SMBG, level 1 or Level 2/3 hypoglycemia rates, and weekly insulin doses. Conclusion: Safety and efficacy outcomes were generally comparable among individuals with T2D treated with efsitora or once-daily comparator, regardless of GLP-1 RA use, across QWINT trials. Disclosure A.Y. Cheng: Advisory Panel; Current; Abbott Diabetes. Speaker's Bureau; Current; Abbott Diabetes, Amgen Canada. Consultant; Current; Aspen Pharmacare. Speaker's Bureau; Current; Astellas Pharma Inc., AstraZeneca. Advisory Panel; Current; Bausch Health, Canada. Speaker's Bureau; Current; Bausch Health, Canada. Advisory Panel; Current; Bayer AG. Speaker's Bureau; Current; Bayer AG. Advisory Panel; Current; Boehringer Ingelheim International GmbH. Speaker's Bureau; Current; Boehringer Ingelheim International GmbH. Advisory Panel; Current; Biomea Fusion. Speaker's Bureau; Current; Dexcom, Inc. Advisory Panel; Current; Dexcom, Inc. Speaker's Bureau; Current; Eisai Co., Ltd. Advisory Panel; Current; Eisai Co., Ltd., Eli Lilly and Company. Speaker's Bureau; Current; Eli Lilly and Company. Advisory Panel; Current; Gan Current; Insulet Corporation. Advisory Panel; Current; HLS Therapeutics Inc. Speaker's Bureau; Current; HLS Therapeutics Inc. Advisory Panel; Current; Merck Current; Medtronic. Advisory Panel; Current; Novo Nordisk. Speaker's Bureau; Current; Novo Nordisk. Advisory Panel; Current; Sanofi. Speaker's Bureau; Current; Sanofi. Consultant; Current; Sandoz International GmbH, Vertex Pharmaceuticals Incorporated. M. Davies: Advisory Panel; Current; AbbVie Inc., Amgen Inc., Biomea Fusion, Roche Pharmaceuticals, Regeneron Pharmaceuticals Inc., Daewoong Pharmaceutical. Other - Advisory Panel and Speaker Bureau; Current; Sanofi. Advisory Panel; Current; Zealand Pharma A/S, GlaxoSmithKline plc. Other - Advisory Panel, Speaker Bureau, Grants in support of Trials; Current; AstraZeneca. Other - Consultant/Advisor/Speaker Bureau/Grants in support of Trials; Current; Boehringer Ingelheim International GmbH. Other - Consultant/Advisor/Speaker Bureau; Current; Eli Lilly and Company. Other - Consultant/Advisor/Speaker Bureau/Grants in support of Trials; Current; Novo Nordisk. Speaker's Bureau; Current; Zuellig Pharma Holdings Pte. Ltd. Advisory Panel; Current; EktaH. T. Battelino: Advisory Panel; Current; Novo Nordisk, Eli Lilly and Company, Sanofi, Medtronic, Dexcom, Inc., Roche Diabetes Care, Abbott. Speaker's Bureau; Ended; Novo Nordisk, Eli Lilly and Company. Speaker's Bureau; Current; Sanofi, Medtronic. Speaker's Bureau; Ended; Dexcom, Inc., Abbott. Research Support; Current; Sanofi. Advisory Panel; Ended; Tandem Diabetes Care, Inc. Research Support; Current; Tandem Diabetes Care, Inc., Novo Nordisk, Medtronic. C. Tu: Advisory Panel; Current; Sanofi. Research Support; Current; Sanofi. Speaker's Bureau; Current; Sanofi. Advisory Panel; Current; Abbott. Speaker's Bureau; Current; Abbott. Advisory Panel; Current; Lilly. Research Support; Current; Lilly. Speaker's Bureau; Current; Lilly, Amgen Inc. Advisory Panel; Current; Novo Nordisk. Research Support; Current; Bayer AG. Research Support; Ended; Boehringer Ingelheim International GmbH. Advisory Panel; Current; Madrigal Pharmaceuticals, Inc., Insulet Corporation. Speaker's Bureau; Ended; AstraZeneca. K. Syring: Employee; Current; Eli Lilly and Company. Stock/Shareholder; Current; Eli Lilly and Company. S. Cp: None. M.B. Davidson: Employee; Current; Eli Lilly and Company. Stock/Shareholder; Current; Eli Lilly and Company. Funding Eli Lilly and Company

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Cite This Study

CHENG et al. (Fri,) studied this question.

synapsesocial.com/papers/6a250c507def13d035e1c60f https://doi.org/https://doi.org/10.2337/db26-1746-p

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