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Phase 3 N=986 Randomized Treatment

A Study of Insulin Efsitora Alfa (LY3209590) Compared With Insulin Degludec in Participants With Type 2 Diabetes Currently Treated With Basal Insulin

Type 2 Diabetes

Enrolled (actual)
986
Serious AEs
14.2%
Results posted
Jun 2025
Primary outcome: Primary: Change From Baseline in Hemoglobin A1c (HbA1c) [Noninferiority] — -0.81; -0.72 Percentage of HbA1c

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Insulin Efsitora Alfa (Drug); Insulin Degludec (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Eli Lilly and Company
Primary completion
May 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
Change From Baseline in Hemoglobin A1c (HbA1c) [Noninferiority]
-0.81; -0.72
SECONDARY
Change From Baseline in Hemoglobin A1c (HbA1c) [Superiority]
-0.81; -0.72 0.088
SECONDARY
Nocturnal Hypoglycemia Event Rate
0.11; 0.10 0.897
SECONDARY
Percentage of Time in Glucose Range Between 70 and 180 mg/dL (3.9 and 10.0 mmol/L)
61.37; 60.95 0.722
SECONDARY
Change From Baseline in Fasting Glucose
-30.97; -30.13 0.605
SECONDARY
Weekly Insulin Dose at Week 26
333.20; 363.20 0.003 sig
SECONDARY
Hypoglycemia Event Rate
0.84; 0.74 0.430
SECONDARY
Change From Baseline in Body Weight
2.27; 2.20 0.756
SECONDARY
Percentage of Time in Hypoglycemia Range
0.36; 0.22 0.021 sig
SECONDARY
Percentage of Time in Hyperglycemia Range
37.25; 38.24 0.417
SECONDARY
Change From Baseline in Treatment-Related Impact Measure - Diabetes (TRIM-D)
10.03; 6.88; 10.09; 6.53; 10.33; 6.98 <0.001 sig
SECONDARY
Diabetes Treatment Satisfaction Questionnaire-Change Version (DTSQc) - Treatment Satisfaction Score: Week 26
14.9; 12.3
SECONDARY
Diabetes Treatment Satisfaction Questionnaire-Change Version (DTSQc) - Treatment Satisfaction Score: Week 52
15.1; 12.3
SECONDARY
Diabetes Treatment Satisfaction Questionnaire-Change Version (DTSQc) - Treatment Satisfaction Score: Week 78
15.4; 11.7

Summary

The reason for this study is to see if the study drug insulin efsitora alfa (LY3209590) is safe and effective in participants with Type 2 diabetes that have already been treated with basal insulin. The study consists of a 3-week screening/lead-in period, a 78-week treatment period and a 5-week safety follow-up period. The study will last up to 86 weeks.

Eligibility Criteria

Inclusion Criteria

  • Have been diagnosed with Type 2 diabetes according to the World Health Organization (WHO) criteria treated with basal insulin
  • Are receiving ≥10 units of basal insulin per day and ≤110 units per day at screening
  • Have HbA1c value of 6.5% - 10% inclusive, at screening
  • Have a Body mass index (BMI) less than or equal to 45 kilogram/square meter (kg/m²)
  • Have been treated with one of the following stable insulin regimens at least 90 days prior to screening:
  • once daily U100 or U200 of insulin degludec
  • once daily U100 or U300 of insulin glargine
  • once or twice daily U100 of insulin detemir, or
  • once or twice daily human insulin NPH
  • acceptable non insulin glucose lowering therapies may include 0 to up to 3 of the following:
  • dipeptidyl peptidase (DPP-4) IV inhibitors
  • SGLT2 inhibitors
  • metformin
  • alphaglucosidase inhibitors or,
  • Glucagon-Like Peptide-1 (GLP-1) receptor agonists
  • Participants must be willing to stay on stable dose throughout the study

Exclusion Criteria

  • Have Type 1 diabetes mellitus
  • Have acute or chronic hepatitis, cirrhosis, or obvious clinical signs or symptoms of any other liver disease, except Nonalcoholic Fatty Liver Disease (NAFLD)
  • Estimated glomerular filtration rate (eGFR) <20 milliliters/minute/1.73 square meter (m²)
  • Have active or untreated malignancy
  • Are pregnant
  • Have a significant weight gain or loss the past 3 months
  • Have received anytime in the past 6 months, any of the following insulin therapies:
  • prandial insulin
  • insulin mixtures
  • inhaled insulin
  • U-500 insulin, or
  • continuous subcutaneous insulin infusion therapy
  • Have had any of New York Heart Association Class IV heart failure or any of the following CV conditions in the past 3 months:
  • acute myocardial infarctions
  • cerebrovascular accident (stroke), or
  • coronary bypass surgery
  • Gastrointestinal: have undergone gastric bypass (bariatric) surgery, restrictive bariatric surgery (Lap-Band) or sleeve gastrectomy within 1 year prior to screening
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT05275400). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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