AstraZeneca Diabetes Drug Combination Shows Promise in Study

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  • Bydureon and Forxiga reduced weight, blood pressure in trial
  • Combination may be additional option before insulin treatment

AstraZeneca Plc said a combination of two diabetes medications significantly lowered blood sugar, weight and blood pressure in a study that will support its use to delay insulin treatment.

The approved drugs Bydureon and Forxiga together reduced a measure of blood sugar more than either drug alone, the main goal of the trial of almost 700 patients. The U.K.’s second-biggest drugmaker presented the data Friday at the European Association for the Study of Diabetes meeting in Munich.

Doctors often prescribe insulin for patients whose blood sugar remains high after taking metformin, the generic medicine that’s the first line of treatment. Drugmakers are exploring whether insulin injections can be delayed by therapies such as Bydureon and Forxiga, as well as competing products from Novo Nordisk A/S, Eli Lilly & Co. and Sanofi. Injected insulin can cause low blood-sugar levels and weight gain, which are especially dangerous in people with diabetes.

“Insulin has a cost which comes attached to it,” Fouzia Laghrissi-Thode, vice president of cardiovascular and metabolic diseases at Cambridge, England-based Astra, said in an interview. Delaying its use “may be a big advantage.”

Cheap Insulin

Lower-cost copies of injectable insulin are becoming available, after the U.S. Food and Drug Administration approved Eli Lilly’s biosimilar version of Sanofi’s Lantus. Copies will be available at a 30 percent discount to branded insulin, said Laghrissi-Thode. As a result, the cost of the treatments from Astra and others will have to be considered in the context of how much they benefit patients, she said.

Astra’s clinical trial found that Bydureon and Forxiga met secondary goals of reducing body weight and blood pressure more than either medicine alone. The combination had similar rates of adverse events to the medicines administered individually, and the most common ones were diarrhea, injection-site nodules, nausea and urinary tract infections.

Flushing Sugar

Bydureon belongs to a class of medicines known as GLP-1s, which stimulate insulin production in the body, while Forxiga is a pill that helps flush out excess sugar through the urine. Astra’s clinical trial was the first to combine the two types of anti-diabetes medicines. Its competitors Sanofi, Novo and Eli Lilly are betting on their own different combinations of anti-diabetes medications and insulin.

Combination treatment is the likely future of type 2 diabetes therapy, said Serge Jabbour, director of the Diabetes Center at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia. Some physicians were already prescribing Bydureon with Forxiga before the release of Astra’s data, because the medications address different types of malfunctions in the bodies of patients with Type 2 diabetes, he said.

“Now we know that when people have type 2 diabetes they have at least eight defects, not just two -- what we thought initially,” said Jabbour, who was paid by AstraZeneca to lead the study. “We believe that there are probably more defects that we have not discovered yet. That’s why one drug will not really do it.”