Insulin degludec/liraglutide: innovation-driven combination for advancement in diabetes therapy

Existing pharmacological therapies with basal insulins are limited by weight gain and hypoglycemia, while those with glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) are limited by issues of efficacy when used alone. However, when used in combination they show a complementarity of action, in terms of reducing the incidence of hypoglycemia while providing sufficient glycemic control, that might help counterbalance their individual limitations. Clinical trials have demonstrated better efficacy and safety profile of this combination. Insulin degludec/liraglutide (IDegLira) is a once-daily fixed-dose combination of ultra-long-acting basal insulin degludec (IDeg) and GLP-1 RA, liraglutide.

We reviewed published data regarding chemistry, pharmacokinetics, pharmacodynamics, clinical efficacy and safety of IDeg, liraglutide and the co-formulation. Literature was searched from the electronic medical database PubMed up to December 2013.

Preliminary studies on IDegLira indicate improved overall glycemic control, better safety profile with reduction in bodyweight and low rate of hypoglycemia compared to IDeg but higher rates of hypoglycemia than liraglutide therapy alone. Further, simplicity of fixed-dose combination offers an additional advantage of improved treatment adherence. IDegLira might be used similar to basal insulins in the current treatment algorithms, but with a greater preference for initiation instead of two or more oral drugs.