degludec/liraglutide (Xultophy)

Indications

• adults with type 2 diabetes inadequately controlled on basal insulin (< 50 units/day) or liraglutide (<= 1.8 mg/day)
  • may afford better glycemic control than glargine

Dosage

• prefilled pen device containing a fixed dose of degludec & liraglutide
• each unit of Xultophy 100/3.6 contains:
  • 1 unit of degludec & 0.036 mg of liraglutide
• QD dosing
• starting dose is 16 units (16-units degludec & 0.58 mg liraglutide
• maximum dose of 50 units corresponds to 50 units of degludec & 1.8 mg of liraglutide

Adverse effects

• nausea

• drug adverse effects of hypoglycemic agents

Clinical trials

DUAL V Randomized Clinical Trial

• study characteristics
  • 560 adults type 2 diabetes
  • hemoglobin A1c of 7-10% while taking glargine & metformin
  • patients randomized to either continue glargine or switch to once-daily injections of degludec/liraglutide
• results
  • at 26 weeks, mean HbA1c diminished by 1.8% with degludec/liraglutide vs 1.1% with glargine
  • degludec/liraglutide recipients lost an average of 1.4 kg; glargin ecipients gained 1.8 kg
  • degludec/liraglutide recipients had fewer episodes of hypoglycemic

More general terms

• hypoglycemic combination

Components

• insulin degludec (Tresiba)
• liraglutide (Victoza, Saxenda)