UK patients with type II diabetes could get access to a new combination treatment to control their blood glucose following the nationwide launch of Novo Nordisk’s Xultophy this week.

Xultophy is a once-daily single injection combination of long-acting basal insulin Tresiba and Novo’s blockbuster GLP-1 receptor agonist Victoza (liraglutide), which the firm says can help patients achieve better blood glucose control with reduced treatment-related side effects such as hypoglycaemia and weight gain.

The claims are based on new head-to-head data from the DUAL V trial, showing that Xultophy induced a significant reduction in blood sugar, body weight change, and lower rate of hypoglycaemia in type II diabetics uncontrolled on insulin glargine versus those boosting their dose of insulin, the firm said. 

Also, earlier results from the DUAL II study indicated that the combination caused a 1.9% reduction in blood sugar (measured by HbA1c) from baseline, weight loss of 2.7kg from baseline, and low rate of hypoglycaemia compared to Tresiba.

Unmet need

Around three million people have diabetes in the UK, already costing the NHS around £14 billion a year, but the number is expected to surge to four million by 2025. Given that 90% of these are type II diabetics, nearly three-quarters of which remain uncontrolled despite basal insulin regimens, the need for new and effective therapies is urgent.

A key issue is that patients are concerned about the side-effects of insulin, which can impact on adherence and therefore blood sugar control, ultimately leaving patients at a much higher risk of developing potentially avoidable complications. Novo is hoping that Xultophy will help address this, as the risk of such side effects is lower.

Novo has priced Xultophy lower than the sum of the two individual components, with each dose step costing less than 11 pence. For patients switching to Xultophy from insulin, the starting dose is 16 dose steps which will cost around £1.70 per day, the firm noted.