Once-weekly insulin efsitora alfa versus once-daily insulin glargine U100 in adults with type 2 diabetes treated with basal and prandial insulin (QWINT-4): a phase 3, randomised, non-inferiority trial.
Summary
In adults with type 2 diabetes already using basal–bolus therapy, once-weekly efsitora was non-inferior to daily glargine U100 for HbA1c control over 26 weeks in a phase 3 treat-to-target trial. The weekly regimen offers reduced injection burden without compromising efficacy.
Key Findings
- Once-weekly efsitora was non-inferior to daily glargine U100 for HbA1c change at 26 weeks.
- Trial included adults on basal–bolus regimens across multiple countries and sites.
- Weekly dosing offers potential adherence and satisfaction benefits in high-burden regimens.
Clinical Implications
Weekly basal insulin may be considered in basal–bolus users to reduce burden; clinicians should monitor for glycemic targets and individualize prandial dosing alongside the weekly basal strategy.
Why It Matters
Extends weekly basal insulin evidence to the complex basal–bolus population, addressing a high-burden regimen where reducing injection frequency could meaningfully improve adherence.
Limitations
- Open-label design with potential bias
- 26-week duration limits longer-term safety and durability assessments
Future Directions
Assess long-term durability, hypoglycemia patterns, patient-reported outcomes, and economic impact of weekly basal insulin in basal–bolus users.
Study Information
- Study Type
- RCT
- Research Domain
- Treatment
- Evidence Level
- I - Phase 3 randomized controlled non-inferiority trial
- Study Design
- OTHER