EASD24: Lilly’s Weekly Insulin Efsitora Demonstrates Efficacy but Raises Hypoglycemia Concerns

Efficacy in Type 1 and 2 Diabetes:
Eli Lilly's once-weekly insulin efsitora (efsitora alfa) has shown similar reductions in HbA1C levels compared to daily insulin injections in adults with type 1 and type 2 diabetes, as demonstrated in the Phase III QWINT-2 and QWINT-5 trials.

Hypoglycemia Concerns:
Despite the efficacy, there are concerns about higher rates of severe or clinically significant hypoglycemic events with efsitora compared to daily insulin. In QWINT-2, no severe hypoglycemia was observed in the efsitora group, but in QWINT-5, 10% of patients on efsitora experienced severe hypoglycemia compared to 3% in the degludec group.

Clinical Trials:
The QWINT-2 trial compared efsitora to insulin degludec in 928 participants with type 2 diabetes over 52 weeks, while QWINT-5 compared efsitora to insulin degludec in 893 participants with type 1 diabetes over 26 weeks.

Market Impact:
The development of once-weekly insulin could significantly reduce the burden on patients with diabetes, offering a more convenient alternative to daily injections. Eli Lilly is in competition with Novo Nordisk, which is also developing a weekly insulin, Icodec.

Publication and Presentation:
The results from QWINT-2 and QWINT-5 were presented at the European Association for the Study of Diabetes (EASD) 2024 meeting and concurrently published in the New England Journal of Medicine and The Lancet.