Lixisenatide

(Adlyxin®)

Lixisenatide

Drug updated on 4/26/2024

Dosage FormInjection (subcutaneous; 50 mcg/mL, 100 mcg/mL)
Drug ClassGlucagon-like peptide 1 (GLP-1) receptor agonists
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

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Summary
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  • Lixisenatide (Adlyxin) is indicated as an adjunct to diet and exercise for improving glycemic control in adults with type 2 diabetes mellitus. It has shown mixed results when compared to other glucagon-like peptide-1 receptor agonists (GLP-1 RAs), demonstrating favorable outcomes in reducing glycated hemoglobin and achieving glycemic targets, especially when used in fixed-ratio combinations or compared to premix insulin.
  • Eleven systematic reviews/meta-analyses focused on the efficacy and safety of lixisenatide, particularly its use among adults with type 2 diabetes mellitus.
  • In terms of cardiovascular events, lixisenatide was associated with reductions but showed variability in effectiveness. Subcutaneous semaglutide and albiglutide were often more effective than lixisenatide among patients with cardiovascular disease or chronic kidney disease.
  • The impact of lixisenatide on weight management varied; some comparisons showed less weight reduction compared to other GLP-RAs like oral semaglutide. However, fixed-ratio combinations involving this drug tended towards favorable outcomes regarding body weight management.
  • Gastrointestinal intolerance was a common concern across all GLP-RAs, including Adlyxin; however, it generally had lower rates of nausea/vomiting than exenatide or liraglutide, especially when used alongside insulin glargine, which could enhance gastrointestinal tolerability.
  • Variability in benefits from using GLP-RAs such as Adlyxin can occur according to patient baseline characteristics, such as duration/history of diabetes, renal function, or cardiovascular diseases, showing pronounced benefits for cerebrovascular outcomes amongst those having shorter durations or higher eGFRs.
  • The prevention efficiency against cardiovascular events and progression of renal diseases varies between drugs/subgroups: subcutaneous semaglutides and albiglutides were particularly effective for patients with cardiovascular diseases, while canagliflozin and liraglutide showed pronounced benefits in those having chronic kidney disease.
  • Lixisenatide (Adlyxin) offers potential benefits in weight management when used appropriately. Its safety and tolerability profile is comparable to other agents within the class, with certain fixed-ratio combinations possibly offering enhanced gastrointestinal tolerability.

Product Monograph / Prescribing Information

Document TitleYearSource
Adlyxin (lixisenatide) Prescribing Information.2023Sanofi-Aventis U.S. LLC, Bridgewater, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
GLP-1 receptor agonists and risk of adverse cerebrovascular outcomes in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.2022Endocrine Society
Once-daily oral semaglutide versus injectable GLP-1 RAs in people with type 2 diabetes inadequately controlled on basal insulin: Systematic review and network meta-analysis.2021Diabetes Therapy
Comparison of the effects of 10 GLP-1 RA and SGLT2 inhibitor interventions on cardiovascular, mortality, and kidney outcomes in type 2 diabetes: A network meta-analysis of large randomized trials.2021Prime Care Diabetes
Comparative efficacy of glucagon-like peptide 1 receptor agonists and sodium glucose cotransporter 2 inhibitors for prevention of major adverse cardiovascular events in type 2 diabetes: a network meta-analysis.2021Journal of Cardiovascular Pharmacology
Efficacy and safety of iGlarLixi versus IDegAsp: Results of a systematic literature review and indirect treatment comparison.2021Diabetes, Obesity and Metabolism
Gastrointestinal adverse events with insulin glargine/ lixisenatide fixed-ratio combination versus glucagon-like peptide-1 receptor agonists in people with type 2 diabetes mellitus: A network meta-analysis.2020Diabetes, Obesity and Metabolism
Insulin glargine/lixisenatide fixed-ratio combination (iGlarLixi) compared with premix or addition of meal-time insulin to basal insulin in people with type 2 diabetes: A systematic review and Bayesian network meta-analysis.2020Diabetes, Obesity and Metabolism
Major cardiovascular events, heart failure, and atrial fibrillation in patients treated with glucagon-like peptide-1 receptor agonists: An updated meta-analysis of randomized controlled trials.2020Nutrition, Metabolism and Cardiovascular Diseases
Cardiovascular outcomes, heart failure and mortality in type 2 diabetic patients treated with glucagon-like peptide 1 receptor agonists (GLP-1 RAs): A systematic review and meta-analysis of observational cohort studies.2020International Journal of Clinical Practice
Insulin glargine/lixisenatide fixed-ratio combination (iGlarLixi) compared with premix or addition of meal-time insulin to basal insulin in people with type 2 diabetes: a systematic review and bayesian network meta-analysis.2020Diabetes, Obesity and Metabolism
Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: A systematic review and meta-analysis of cardiovascular outcome trials.2019Lancet Diabetes Endocrinology

Clinical Practice Guidelines