The change in Fibrosis-4 index in Japanese patients with type 2 diabetes treated by a fixed-ratio combination therapy of insulin degludec and liraglutide: A retrospective observational study

AimThe efficacy of titratable fixed-ratio combination therapy by a combination preparation of insulin degludec and liraglutide (IDegLira) in Japanese patients with type 2 diabetes, focusing particularly on the change in Fibrosis-4 index (FIB-4), a noninvasive method for the evaluation of liver fibrosis, was investigated.MethodsAs the full analysis set, 113 patients were treated with IDegLira. The patients were categorized into two groups according to the absence (GLP-1RA-naive group, n = 72) or presence (GLP-1RA-treated group, n = 41) of glucagon-like peptide-1 receptor agonist (GLP-1RA) use before starting IDegLira. The clinical parameters were retrospectively determined over 6 months.ResultsThe glycated hemoglobin value was significantly reduced in both groups. The bodyweight significantly decreased from 67.4 +/- 11.0 kg at baseline to 66.4 +/- 11.6 kg at 6 months in the GLP-1RA-naive group, although it slightly increased in the GLP-1RA-treated group. FIB-4 significantly decreased from 1.60 +/- 0.84 at baseline to 1.49 +/- 0.74 at 6 months in the GLP-1RA-naive group. Although FIB-4 significantly increased in the GLP-1RA-treated group, it remained within the low-risk level for liver fibrosis.ConclusionFixed-ratio combination therapy using IDegLira for the treatment of type 2 diabetes is useful for glycemic control and weight management. In particular, IDegLira may be more effective for lowering FIB-4 than adding unused oral antidiabetic agents or increasing the dose of insulin in GLP-1RA-naive patients. The efficacy of a combination preparation of insulin degludec and liraglutide in patients with type 2 diabetes, focusing particularly on the change in the FIB-4, was investigated. Fixed-ratio combination therapy using insulin degludec and liraglutide is useful for liver protection, improving blood glucose levels, and preventing an increase in bodyweight.image