ADA Reports Efficacy of Weekly Insulin Efsitora Compared to Glargine in Adults with Type 2 Diabetes

A recent study published in the New England Journal of Medicine found that once-weekly insulin efsitora alpha (efsitora) is just as effective as the standard once-daily insulin glargine in lowering HbA1c levels among adults with type 2 diabetes. The 52-week phase 3 trial involved 795 participants who had not previously used insulin, making it a significant step forward in diabetes management options.

Participants were randomly assigned to receive either weekly efsitora, initiated at 100 units with dose adjustments every four weeks, or daily glargine, with dose modifications based on glycemic goals. Results showed that the mean HbA1c decreased from approximately 8.2% at baseline to about 7.05% with efsitora, and from 8.28% to 7.08% with glargine. The analysis confirmed that efsitora was noninferior to glargine, though it did not demonstrate superiority.

An important finding was that the rate of serious hypoglycemia events was lower in the efsitora group (0.50 events per participant-year) compared to the glargine group (0.88 events per participant-year). Additionally, the average weekly insulin dose was somewhat lower with efsitora at 289.1 units per week versus 332.8 units with glargine.

The study offers promising evidence that weekly insulin efsitora could simplify treatment regimens without compromising effectiveness, potentially improving adherence and outcomes for patients. Several authors involved disclosed ties to Eli Lilly, which is developing efsitora and funded the study.

For more details, refer to the publication: Julio Rosenstock et al., "Weekly Fixed-Dose Insulin Efsitora in Type 2 Diabetes without Previous Insulin Therapy," NEJM, 2025. Source: https://medicalxpress.com/news/2025-06-ada-insulin-efsitora-noninferior-glargine.html