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Lilly’s Basal Insulin Peglispro Shows Superiority to Sanofi’s Lantus in A1c Reduction

Twitter summary: Lilly’s new basal #insulin Peglispro superior to Sanofi’s Lantus in A1c reduction, though some potential liver safety and hypo concerns

On September 4, Eli Lilly (Lilly) announced results from its phase 3 IMAGINE trials comparing Lilly’s basal insulin peglispro (BIL) to Sanofi’s Lantus (insulin glargine) in type 1 diabetes. BIL insulin works primarily on the liver and less on peripheral tissue (like current insulins), more closely mimicking the way insulin works in someone without diabetes.

While Lilly has yet to release exact data from the trials comparing its new insulin (BIL) to Lantus, there were three positive high-level takeaways:

  • Improved A1c – in both type 1 and type 2 diabetes.

  • Less hypoglycemia at night – in both type 1 and 2 patients.

  • Weight loss –Type 1 patients on Lilly’s new insulin lost weight on average (regardless of A1c reduction), while those on Lantus tended to gain weight. Type 2 patients on BIL tended to gain less weight than those on Lantus.

However, the IMAGINE results also indicated three concerns with Lilly’s new basal insulin:

  • Increased daytime and overall hypoglycemia – in both type 1 and type 2.

  • Increased severe hypoglycemia in type 1 diabetes (situations in which another person needed to help the patient because of low blood glucose)

  • Increased liver and cardiovascular side effects – Lilly’s new insulin was associated with increases in certain liver enzymes, triglycerides, blood pressure, and LDL cholesterol, as well as reductions in HDL cholesterol.

Lilly plans to submit its new basal insulin to the FDA in the first quarter of 2015, meaning a decision could come by the end of 2015 or early 2016. –AJW