Scottish green light for Suliqua and metformin combo for type 2 diabetes

By Editor
17th April 2020

The Scottish Medicines Consortium (SMC) has recommended Suliqua™ for restricted use in combination with metformin for the treatment of adults with type 2 diabetes in Scotland.

It can be used to improve glycaemic control when this has not been provided by metformin alone, or metformin combined with another oral glucose-lowering medicinal product or with basal insulin.

The SMC has restricted the use of Suliqua to use in patients who are uncontrolled on basal insulin (glycosylated haemoglobin [HbA1c] > 7.5% [59mmol/mol]) and for whom a GLP-1 receptor agonist is appropriate as an add-on intensification therapy to basal insulin analogues.

The combination improved glycaemic control compared with insulin glargine alone in adults with inadequately controlled type 2 diabetes, the manufacturer Sanofi said. By year five of Suliqua being in Scotland, it is estimated that 4,485 people living with type 2 diabetes could be eligible for this treatment.

Currently, between 17% and 38% of patients remain uncontrolled on basal insulin and approximately half of people with diabetes, are not reaching their glycaemic target despite using oral anti-diabetic medications (OADs) and/or basal insulin.

The SMC recommendation of the once-daily injection is based on the phase III study, LixiLan-L.

The study found that when added to metformin insulin glargine/lixisenatide demonstrated greater reductions in HbA1c at week 30 in comparison with insulin glargine 100 Units/mL. Suliqua showed greater reductions in HbA1c from baseline compared with insulin glargine (–1.1% vs. –0.6%, P < 0.0001), reaching a mean final HbA1c of 6.9% (52 mmol/mol) compared with 7.5% (58 mmol/mol) for insulin glargine. HbA1c <7.0% (53 mmol/mol) was achieved in 55% of Suliqua patients compared with 30% on insulin glargine. For the secondary outcome of weight change, a reduction of 0.7kg was observed in patients treated with insulin glargine/lixisenatide versus a 0.7kg increase in those treated with insulin glargine. The combination is not licensed for weight reduction. 

Prof Mike Baxter, Medical Therapy Area Expert for Sanofi, said: “More than half of people currently living with type 2 diabetes struggle to achieve glycaemic control on current available therapies, so we’re delighted to be able to offer a treatment option that may help more people to achieve optimal control. Suliqua offers simple administration of an insulin glargine and lixisenatide fixed ratio combination in a single daily injection. Its availability via NHS Scotland demonstrates Sanofi’s continued commitment to addressing the unmet needs in people living with type 2 diabetes.”

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