Insulin Efsitora Versus Degludec in Adults with Type 2 Diabetes Using Basal Insulin: QWINT-3 Japan Subgroup Analysis

The phase 3 QWINT-3 study demonstrated that once-weekly insulin efsitora (efsitora) was noninferior to once-daily insulin degludec (degludec) in reducing glycated hemoglobin A1c (HbA1c) at week 26 (primary end point) in adults with type 2 diabetes (T2D) who had previously received insulin. A subgroup analysis of QWINT-3 participants from Japan is presented. QWINT-3 was a phase 3, multicenter, randomized, parallel-design, open-label study. Participants were randomized in a 2:1 ratio to receive efsitora or degludec. All participants from Japan were included in this preplanned subgroup analysis. End points investigated included changes in HbA1c from weeks 0 to 26 and throughout the treatment period (weeks 0–78), time spent in the glucose range from weeks 22 to 26 and during the initial dosing period (weeks 0−12), fasting blood glucose from weeks 0 to 78, and incidence and rate of hypoglycemia from weeks 0 to 78. Overall, 131 participants from Japan were randomized to efsitora (n = 87) or degludec (n = 44). Demographics and baseline characteristics were balanced between treatment groups. From weeks 0 to 26, HbA1c decreased from 7.64% to 6.82% in the efsitora group and from 7.56% to 7.13% in the degludec group (estimated treatment difference: −0.31% [95% confidence interval (CI), −0.57 to −0.05]). Rates of level 2 or level 3 hypoglycemic events were generally low and similar between efsitora and degludec. From weeks 0 to 78, one severe hypoglycemic event was reported for efsitora; none were reported for degludec. Once-weekly efsitora was similar to once-daily degludec in lowering HbA1c in Japanese QWINT-3 participants with T2D already receiving daily basal insulin. Efficacy and safety were consistent with the overall QWINT-3 study population. This subgroup analysis suggests that efsitora is well tolerated and effective as a once-weekly basal insulin in Japanese adults with T2D inadequately controlled with daily basal insulin. ClinicalTrials.gov identifier: NCT05275400. In a clinical trial called QWINT-3, researchers studied a new type of basal insulin called efsitora, which is injected once a week, and compared it with insulin degludec, a commonly used insulin injected once a day, in people with type 2 diabetes who were already using a daily basal insulin but still needed better blood sugar control. This study looked specifically at Japanese people who participated in the QWINT-3 trial. The study shows that once-weekly insulin efsitora worked just as well as once-daily insulin degludec for Japanese adults with type 2 diabetes who were already using a daily basal insulin. Efsitora was as safe and lowered blood sugar in Japanese participants as well as it did in participants from other countries in the QWINT-3 study. The study shows that once-weekly insulin efsitora helps lower blood sugar in Japanese adults with type 2 diabetes who are already using a daily basal insulin, but who need better blood glucose control. The study also shows that for Japanese adults with type 2 diabetes who need basal insulin, taking insulin once a week may be a convenient and effective choice.