Summary

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• Adlyxin (lixisenatide) is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
• This summary is based on the review of 11 systematic review(s)/meta-analysis(es). ^[1-11]
• Cerebrovascular Outcomes: GLP-1RAs, including lixisenatide, significantly reduced the risk of adverse cerebrovascular outcomes (RR, 0.83; 95% CI, 0.76-0.91), nonfatal stroke (RR, 0.85; 95% CI, 0.76-0.94), and ischemic stroke (RR, 0.73; 95% CI, 0.60-0.89), but did not significantly reduce the risk of fatal stroke (RR, 0.80; 95% CI, 0.61-1.05) or hemorrhagic stroke (RR, 0.92; 95% CI, 0.51-1.64).
• Glycemic Control and Weight Reduction: Once-daily oral semaglutide 14 mg achieved greater reductions in HbA1c (treatment differences: -0.42 to -1.32%) and weight (treatment differences: -2.21 and -2.39 kg) compared to lixisenatide.
• Cardiorenal Events: Lixisenatide was less effective in reducing major adverse cardiovascular events (HR 0.73, 95% CI 0.55-0.96) and hospitalization for heart failure/kidney function progression compared to other GLP-1 RAs such as semaglutide and dapagliflozin.
• Other Cardiovascular and Mortality Outcomes: GLP-1 receptor agonists, including lixisenatide, significantly reduced major adverse cardiovascular events (MH-OR 0.87) and all-cause mortality (MH-OR 0.89) but had neutral effects on atrial fibrillation (MH-OR 0.94).
• Lixisenatide was associated with gastrointestinal adverse events, particularly nausea, vomiting, and diarrhea, with iGlarLixi showing lower rates of nausea and vomiting compared to single-agent GLP-1 RAs like exenatide and liraglutide. 8. iGlarLixi demonstrated lower rates of both confirmed and documented symptomatic hypoglycemia compared to premix insulin, with comparisons to other drugs being inconclusive due to differing study definitions.
• There was no significant increase in the risk of severe hypoglycemia, pancreatitis, or pancreatic cancer with GLP-1RAs, including lixisenatide.
• Benefits of GLP-1RAs were higher in patients with shorter T2DM duration and higher eGFR; Japanese trials showed greater HbA1c reductions compared to international trials; subgroups with cardiovascular disease, heart failure, and chronic kidney disease showed varying effectiveness among different GLP-1RAs.